HEEERE IT ISSSSS Eye Dr Mike. P A Y O L A !!! Pad-my-pocket and company.Read up on PFE.They pushed Calcium Cj\hannel blockers through and now we are descrpting them for angina etc.Again, it's a quick approval with FDA and payola.It takes MUCH longer to prove somehting is harmfull ( Redux;Rezulin etc).But here 's our good canadian brothers hard at work.Sooner or late sh.'t floats.:
harmaceuticals:
Does Corporate Funding Influence Research?
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By Elyse Tanouye
01/08/98
The Wall Street Journal
B1
(Copyright (c) 1998, Dow Jones & Company, Inc.)
Researchers have fiercely debated the risks and benefits of calcium
channel blockers, a class of drugs that treat hypertension and angina.
Now, a new study shows that most of the scientists who have publicly
supported the drugs over the past two years have undisclosed financial
ties to the companies that make them.
The findings raise anew questions about the independence of doctors
and researchers who accept drug-company funding, and the need to
disclose such ties. Scientists have come to rely increasingly on
corporate funding as federal funding has grown ever more elusive, but
those who receive the corporate largess have long argued their findings
aren't influenced by their funding sources.
The new study on the channel-blocker debate could cast doubt on such
assertions. A Canadian research team, which publishes the results today
in the New England Journal of Medicine, studied 70 published articles on
this class of drugs and found that 96% of the authors who supported
calcium channel blockers had financial relationships with the drugs'
makers. Among the researchers who published work critical of the calcium
drugs, only 37% received financial support from the companies that make
these products. Moreover, in only two cases among the 70 research papers
did the scientists involved disclose their ties to drug companies.
The Canadian team stops short of contending that the private funding
swayed the researchers' views and says the support of drug companies for
medical education and research should continue. "Our point in the paper
is not to say that opinions were overtly influenced by relationships,"
but to argue that such relationships should be publicly revealed
outright to avoid suspicion, says University of Toronto professor Allan
S. Detsky, who led the new study. But he concedes that "bias can be a
much more subtle thing."
Some experts see a clear case of conflict of interest. "Physicians
and researchers are human beings, and human beings respond to financial
interests," says Alan Hillman, director of the University of
Pennsylvania's Center for Health Policy in Philadelphia.
Simply disclosing the funding ties, he argues, isn't adequate.
"Disclosure is a necessary step but totally insufficient to help anyone
make decisions about the veracity of the research," Dr. Hillman says,
adding that a watchdog consortium of public and private interests should
be established to oversee and set rules for such funding relationships.
Bruce Psaty, a University of Washington researcher who is a leading
critic of calcium channel blockers, says the conflict-of-interest issue
"is an immensely important topic," and favors full disclosure. Yet he
wasn't convinced the researchers were compromised. "In general, people
don't change their views because they are getting paid. I think drug
companies identify people who have views they want to promote."
Academic researchers commonly accept corporate funding in the form of
grants for research, travel expenses, honorariums for speeches and
payments for consulting. Drug companies typically fund research
favorable to their products and reject studies that look likely to
produce negative results, says Franz H. Messerli of Ochsner Clinic in
New Orleans. Some even go one step further and fund studies that raise
questions about a competing product.
The Canadian study is one of the first scientific reviews offering
hard research into the nexus of scientists' financial backing and the
views they hold. In 1994, one study found that the pharmaceutical
industry's practice of giving physicians money to pay for travel,
speaking or research expenses influenced their prescription
recommendations. But very little has been done to examine the influence
of corporate funding on scientific opinions.
The Canadian researchers focused on the calcium channel-blocker
debate because of the extraordinary number of published opinions on the
topic in medical journals and other medical media gave them a large
enough sample to study.
Calcium channel blockers have annual U.S. sales of about $4 billion,
with the leading brands including Pfizer Inc.'s Norvasc and Procardia
XL, Hoechst AG's Cardizem CD, and Bayer AG's Adalat CC, according to IMS
America, a market-research firm. But it was the older calcium channel
blockers, no longer in wide use, that came under fire in studies that
triggered the calcium channel blocker debate in 1995. Dr. Psaty and
another researcher reported finding links between the older, fast-acting
versions and a higher risk of heart attacks and higher death rates. But
other scientists and drug makers have called the studies flawed and
alarmist. An FDA panel ultimately cautioned against the use of just one
older form of the channel blockers.
In assessing the resulting debate, the Canadian researchers asked
scientists about their funding ties. They found that channel-blocker
critics often lacked financial support from any drug makers.
The team studied 70 articles on the issue and classified them and
their authors as supportive, neutral or critical of calcium channel
blockers. A total of 23 of the 24, or 96%, participating authors who
supported calcium channel blockers had financial relationships with
manufacturers of those drugs, compared with 60% of the 15 neutral
authors and 37% of the drugs' 30 critics.
But among the channel-blocker supporters, 88% of them also got
financial support from companies that make products that compete with
the controversial drugs, lending credence to the team's contention that
the funding didn't dictate the public stance taken by the researchers
questioned.
The latest study's design drew criticism, however, from some experts.
Dr. Messerli of Ochsner Clinic says he declined to participate in the
review because he found the approach "very simplistic and potentially
misleading." He says he was one of the first authors to warn against the
use of fast-acting calcium channel blockers, but those opinions were
voiced before the study's time frame. Subsequent articles could be
interpreted as supportive of the drugs because he believes the newer,
longer-acting versions are safe, he says. He says he doesn't object to
disclosing his financial ties to both makers of the calcium channel
blockers the competing products.
Pfizer and Bayer said they agree that potential conflicts of interest
should be disclosed. A Bayer spokesman said, "While there is the
opportunity for problems and abuse, there are also a series of checks
and balances in place" such as government review of drug claims and
disclosure policies of medical journals. Pfizer added that "The
overwhelming weight of scientific evidence today fully supports the
safety of long-acting calcium channel blockers."
Dr. Detsky, the lead Canadian researcher, said he didn't intend for
his study to stir the pot of the calcium channel blocker controversy.
But he adds: "I'm interested in stirring up the pot on revealing sources
of funding."
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Common Interests
A new study finds that most of the researchers who publicly support
calcium channel blockers have received financial support from companies
that make the drugs, including:
Money to attend symposiums 67%
Speaking honorariums 71%
Money for educational programs 46%
Funding for research 79%
Employment or consulting fees 21%
Source: New England Journal of Medicine
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