Many Authors of Prescription Drug Guidelines Have Financial Ties to Medications They Recommend
Authors of published guidelines for prescribing medications often have financial interests in the companies whose treatments they recommend, according to a study published in the Oct. 20 issue of the journal Nature, the New York Times reports. The study, conducted by the journal, examined more than 200 guidelines deposited last year with the National Guideline Clearinghouse.
NGC, a unit of HHS, summarizes and evaluates the guidelines, and authors are expected to self-report any potential conflicts of interest about the drugs they evaluate, such as owning stock in the drug company or receiving payments from drug makers for speaking at seminars. Almost half of the published guidelines examined in the study contained no information about potential conflicts, and more than one-third of the guidelines stated that the authors of the recommendations had no conflicts.
Researchers found that in about half of the guidelines, at least one author had received research financing from a company that had a connection to the recommendation, and in 43% of the guidelines surveyed, at least one author had been a paid speaker for a relevant company.
According to the Times, the importance of published guidelines has increased in recent years, in part because of a growing demand for "evidence-based" medical practices, which rely on clinical data and expert opinion. Many specialty societies, government agencies and companies publish treatment guidelines, the Times reports.
For instance, Ortho Biotech, which makes the anemia drug Procrit, organized and funded a panel that wrote guidelines for treatment of anemia in people with HIV. The panel, which was led by HIV/AIDS researcher Paul Volberding of the University of California-San Francisco, was cited by the Nature study as an example of a recommendation with potential conflicts of interest.
According to the study, Volberding and the other five panel members all previously had received consulting or lecture fees from Ortho Biotech. The panel recommended the use of Procrit for treatment of HIV-positive patients with anemia.
Volberding said potential conflicts of interest "can be addressed to some degree with full disclosure of the relationship to the company," adding, "There would be serious concern if this were in any way hidden."
David Kahn, a professor of psychiatry at Columbia University, said industry financing does not necessarily create prejudice for guideline authors. "Some of the funding was simply good will by companies with no strong link to any product likely to be highly recommended," Kahn, who has authored several industry-sponsored guidelines, said.
He continued, "In other cases, the outcomes could be guessed at in advance based on known clinical evidence and anticipated sentiment, and the funding was designed to promote expected good news rather [than] to influence its creation" (Bakalar, New York Times, 10/25).