Conflict of Interest Inquisition: Scary Implications

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The national press has been implying that interactions between physicians and pharmaceutical companies are sinister.   The tactic has evidently been to scare patients and show that politicians can come to the rescue.  Yet the effect of this approach may be much scarier than the supposed problem they're shining the limelight on.

 Paul Rubin, Emory Professor of Economics and Law, wrote in the Atlanta Journal Constitution this week that:

..there is no evidence at all that any of the alleged interactions between doctors and pharmaceutical companies has had any harmful effect on any patient. Here is a direct quote from one of the leading articles on the issue: “No study used patient outcome measures.” In other words, no one has actually looked at the effect of pharmaceutical marketing on the welfare of patients. Indeed, some of the researchers writing in this area profess not to care about patient outcomes. In an interchange I had with two authors in this tradition (in the Journal of the American Medical Association) they said that “this fact [that pharmaceutical promotion influenced physicians’ drug choices] rather than the possible merits of the choices themselves, should concern us as physicians.” So we have a set of policies based on an unproven assumption.

The article gives an interesting perspective on the Nemeroff situation at Emory.  To clarify this statement, according to the reports Nemeroff failed to follow an agreement that was made with NIH to disclose conflicts of interest, thus he failed to comply with the rules.   Rubin points out that this focus on conflict of interest will push physician researchers to avoid seeking NIH grants, thus less basic research.

Frank Lichtenberg, a health economist at Columbia University, has shown that newer drugs tend to reduce total health care costs and improve patient outcomes better than older drugs. The policies at issue here may reduce the availability and use of newer drugs because they will make it more difficult for academic physicians to undertake research on drugs and for physicians to learn about newer drugs that are developed. If this happens, patients will suffer — a perverse outcome for policies ostensibly designed to improve patient care.

Now this is a scary scenario

Atlanta Journal Constitution: If politician’s war on drugs continue, patients will suffer

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