[A-List] Unhealthy accumulation

["Michael Keaney" <michael.keaney@xxxxxx>]

Medical journal turns on drug companies

James Meikle

The editor of the British Medical Journal (BMJ) last week called for
"relationships that are less grubby" between drug companies and
doctors.Richard Smith says that greater distance between the industry and
doctors is vital to improving the interests of patients. A themed edition of
the BMJ questions the way companies fund and publish research on products,
the influence of their sales reps on the prescribing practices of family
doctors, and the motives that inspire companies to help fund patient
organisations.
Mr Smith says that advertisements in free publications for doctors, and in
journals such as the BMJ carrying peer-reviewed articles, play their part
in muddying the relationships. More seriously he says that drug companies
are "debasing" drug trials whose publication in journals can apparently
confer scientific approval. Mr Smith offers his "quick guide to corrupting
science to promote drugs". Ploys include avoiding "head-to-head trials" that
could prove "dreadful" to manufacturers of drugs who had spent hundreds of
millions of pounds on their products only to be shown to be inferior to a
rival.

Companies, he says, prefer trials that only prove equivalence to other
drugs. The alternative is to use doses of competitor drugs that are "less
than optimal" or are higher than optimal, so have more side effects.
Mr Smith says: "We hope nobody will see this theme issue as anti-drug
company. Our central argument is that doctors, drug companies and, most
importantly, patients will all benefit from greater distance between doctors
and drug companies."

He is no stranger to this debate. He resigned as a part-time, unpaid
professor at Nottingham University two years ago in protest at its
acceptance of £3.8m from British American Tobacco to fund a centre on
corporate responsibility.

Two weeks ago the British Medical Association, which publishes the BMJ, was
among the organisations that attacked the validity of a paper in the journal
asserting that passive smoking was not linked to coronary disease or lung
cancer. The authors had received money from the tobacco industry.

The Guardian Weekly 20-3-0605, page 11