Wednesday, October 12, 2011

Doctors creating treatment guidelines on drug companies' payroll; 83% in Canada, 58% in U.S.

By Megan Ogilvie and Theresa Boyle, Toronto Star, October 11, 2011
Too many doctors and researchers who help create guidelines for patient care have financial ties to the pharmaceutical industry, according to a study that investigated conflict of interest among a group of major Canadian and U.S. health care organizations.
More than half of panel members who develop clinical practice guidelines for the treatment of diabetes and high cholesterol — conditions which generated $70 billion in drug sales in 2010 — have received compensation by pharmaceutical companies, the U.S. researchers report. The compensation is in the form of consultancy payments, honorariums, speakers’ fees and research grants.
The study, published online Wednesday in BMJ: The British Medical Journal, found the problem was more serious in Canadian specialty organizations, with 83 per cent of panel members having industry ties. Among the American specialty organizations, 58 per cent of panel members had such ties.
“That indicates there is a potential risk of industry influence on guideline recommendations,” said Dr. Jennifer Neuman, the study’s lead author and instructor in the department of preventive medicine at New York’s Mount Sinai School of Medicine.
“Guidelines serve to standardize care and inform evidence-based practice and ultimately to protect patients. Their freedom from bias is very important
Patient Care guidelines, of course, become protocols in medical schools, and in treatment facilities like hospitals and clinics where patients are the recipients of what could easily be, and often is, treatment tarnished by the taint of profit, the profit of those umbilically linked to the pharmaceutical companies.
Ask any doctor who has been practicing for a few years, "When and where was your last post-graduate training, and who paid for it?" and the answer will inevitably be, "At a large resort somewhere exotic, within the last year, sponsored by one of the mega-pharmaceutical corporations!"
Ironically, the 83% of doctors participating in setting treatment guidelines in Canada is significantly higher than the 58% number for American participants. That likely means that Canadian doctors have more hands in the trough of extra profit given their "limit to earnings under the Canadian Health Act"....yeah sure!
There is a trickle of doctors, finally, making their way back to Canada from the U.S. because of the "for-profit" nature of the medical care in the U.S. Fortunately, for Canada, such doctors will be offering care, irrespective of its cost, and detached, at least somewhat, for their capacity to earn fees.
However, the invasion of "treatment protocols" by pharmaceutical-linked practitioners is a red flag that will likely go unnoticed by the federal and provincial authorities responsible for regulating medical practices. Ideally, it would be the College(s) of Physicians and Surgeons that would set guidelines, including caps, for their members, when the pharmaceutical monsters come calling with their fists full of cash. That would at least reduce the influence of those companies on the design of treatment protocols, and could lead to the inclusion of treatments from other medical fraternities in other countries, where the drug company influence is lower, less invasive and the medical profession is less tainted with cash.
(I invite your comments, via e-mail to, jta@kingston.net)

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