NEJM: Angell Decries Research Links to Drug Industry
"[A]cademic medicine has become intertwined with the pharmaceutical and biotechnology industries," departing New England Journal of Medicine editor-in-chief Marcia Angell laments in the latest issue of the journal. The Wall Street Journal reports that Angell lambasted the "large-scale breaching of the boundaries between academic medicine and for-profit industry," calling for researchers to be restricted from investing in the companies whose drugs they study. In her editorial, Angell details the extent to which researchers have become intertwined with drug companies, including receiving grant support, serving as consultants, advisory board members and paid speakers and "allow[ing] themselves to be plied with expensive gifts and trips to luxurious settings" (Bulkeley, 5/18). Angell said, "When the boundaries between industry and academic medicine become as blurred as they are now, the business goals of industry influence the mission of medical schools in multiple ways" (AP/Baltimore Sun, 5/18). This is not the first time NEJM tackled the conflict-of-interest issue. Last February, the journal admitted to violating its own ethics policy when an internal audit turned up 19 articles since 1997 that were written by authors with undisclosed financial ties to the drugs' manufacturers (Monmaney, Los Angeles Times, 5/18). Angell said that she decided to write the editorial after NEJM accepted an article whose list of contributors had so many ties to drug companies that there was no room to publish them all. That article on treating depression by combining drugs and psychoanalysis appears in the current issue.
Profits and Ghost Writers
Angell's comments are accompanied by a new study from Thomas Bodenheimer of the University of San Francisco Medical School that found "academic-industry drug trials have been tainted by profit incentive." Bodenheimer blasted "two growing practices: drug companies' use of for-profit companies instead of not-for-profits ... and industry-hired ghost writers who pen research articles that appear under the names of more-credible academics." After interviewing researchers and reviewing a number of papers, Bodenheimer concluded that "drug companies control research by delaying or preventing publication of adverse results, limiting studies to areas that would boost drug sales and limiting access to the complete data, while researchers see only a portion of continuing results" (Wall Street Journal, 5/18).
New Editor Disagrees
The Boston Globe reports that NEJM's new editor-in-chief, Dr. Jeffrey Drazen, disagrees with Angell. Drazen said Wednesday that "academic researchers should be able to own substantial stock in a company or accept sizeable consultant fees and still accept research support," as long as studies do not involve humans. Drazen is a member of a Harvard Medical School panel that will recommend next week a loosening of the school's restrictions on faculty ties to the drug industry. Angell countered, "Softening its conflict of interest guidelines is exactly the wrong thing for Harvard Medical School to do" (Knox, 5/18).