Harvard psychiatrists under-report drug company payments

If you missed it, I recommend this article in today’s New York Times on child psychiatrists at Harvard University and their apparent under-reporting of consulting payments from drug companies.

It’s a disturbing look at one of the most troubling issues in medicine: the degree to which physicians are financially involved with the drug industry.

That involvement has deepened as the government has cut back on grants to medical researchers and drug companies have stepped in with financial assistance.

Of course, drug company grants can help support top-notch science and further medical innovation. But the risk is that payments can also bias researchers’ and physicians’ judgment as well as their prescribing patterns.

Are doctors more likely to write a prescription for a drug when they’re consulting for the company? Are they more willing to minimize side effects, overstate potential benefits, or overlook the absence of results about long-term use in the scientific literature? Are researchers more inclined to publish only favorable results?

Although there's evidence some of this does occur, many physicians, including one quoted in the New York Times article, insist that patients’ interests always come first and that their professional integrity isn’t comprised by money from pharmaceutical manufacturers.

In the case of the Harvard doctors, their patients are disturbed children, many of whom are prescribed powerful anti-psychotic medications for conditions such as bi-polar disorder, one of the fastest growing diagnoses in child psychiatry. The Harvard group has been enormously influential in expanding the use of anti-psychotic drugs for children across the U.S.

Other experts are convinced there’s potential for a conflict of interest, especially when the payments from drug companies are sizable. This was the case with the Harvard doctors, two of whom apparently each received at least $1.6 million between 2000 and 2007.

For years, the physicians understated this drug company consulting income in reports to the university, according to material compiled by congressional investigators and Sen. Charles Grassley (R-Iowa), who is pushing national legislation that would require pharmaceutical firms to report payments to physicians.

While most universities require researchers to report consulting income, few have systems in place to check their accuracy or actually monitor these reports. “It’s really been an honor system thing,” Dr. Robert Alpern, dean of Yale School of Medicine, told the New York Times.

Physicians and researchers may say "trust us," but that’s hard to do when a situation like the one at Harvard arises.

http://newsblogs.chicagotribune.com/triage/2008/06/harvard-psychia.html
_________________
"Taking money without permission is stealing unless you work for the IRS then it's taxation. Killing people en masse is homicidal mania unless you work for the Army then it's National Defense. Spying on your neighbors is invasion of privacy unless you work for the FBI then it's National Security. Running a whorehouse makes you a pimp & poisoning people makes you a murderer unless you work for the CIA then it's counter intelligence." R. Wilson. ANCAPS Forum Headquarters, Ancapolis