Monday, December 29, 2008

Drug Companies and Doctors

The latest New York Review of Books (Jan. 15, 2009 issue) contains an interesting article by Marcia Angell, former Editor-in-Chief of the New England Journal of Medicine and author of "The Truth About the Drug Companies: How They Deceive Us and What to Do About It."    The article reviews three books critical of the pharmaceutical industry and its relationship with doctors and clinicians:  Side Effects by Alison Bass, Our Daily Meds by Melody Petersen and Shyness by Christopher Lane.  The review details the conflicts of interest and baises in medicine that are the result of the relationship between multi-billion dollar drug companies and doctors.  Angell writes on page 12:

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.  I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor in of The New England Journal of Medicine.

Two trends she points to are particularly disturbing.  One is the increasing prevalence of "off label uses" and the second is the off label use of drugs for children.   She particularly focuses on drugs to treat psychiatric conditions.  Her observations raise questions about how the law should treat these developments. 


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By now you have probably become aware that the NEJM just (withing the past day or two) changed its policy with regard to disclosure of its authors' conflicts of interest, following complaints that the editors had failed to disclose that the author of a lung cancer related study that recommended CT scanning had a financial interest in a patent for a new CT scanner. To the author's credit, she had disclosed this information to the NEJM. I noted the policy change in yesterday's posting on my own blog,, which included a link to a detailed story in the NY Times.
Best regards,
Andy Barovick

Posted by: Andrew J. Barovick | Jan 10, 2009 11:51:18 AM