Articles and editorials in recent issues of US medical journals have been accusing the pharmaceutical industry of misleading the public, manipulating doctors and putting profits before patients. Physician groups medical schools and teaching hospitals are reportedly changing rules to limit the influence of pharmaceutical sales reps. Last month, three top editors of the New England Journal of Medicine publicly sided against the drug industry in a US Supreme Court case over whether patients harmed by government-approved medicines may still sue in state courts.
As more voices have called for change, new guidelines for how drugmakers and doctors should interact are coming from both industries. Doctors say that while some abuses of the past have ended, the industries' dealings remain fraught with potential conflict. This, according to them, is because the sectors depend on each other so much - medicine on drugmakers' research dollars and drugmakers on the credibility researchers give them.
In an April editorial, Dr. Catherine DeAngelis, editor of the Journal of the American Medical Association (JAMA), referred to two studies on past reports about Merck & Co.'s withdrawn pain reliever Vioxx. The reports frequently were penned by ghostwriters and some - on Vioxx studies - minimised the risk of death. Merck has, however, denied the charges.
Top journals are already listing study authors' conflicts of interest. Dozens of medical schools and medical specialty societies are barring gifts to doctors and limiting their other financial ties to the industry. Some schools also bar professors from being paid drug company speakers. One expert noted that drugmakers have stopped giving cash prizes to medical students for presenting favourable research on their drugs at conferences.
Medical groups have been fighting industry influence harder since a 2006 JAMA editorial by 11 prominent doctors urged teaching hospitals to lead in cleaning up conflicts of interest between medicine and industry.
