Tag Archives: conflict of interest

After 5-year FOIA fight, documents show ties between researchers, officials in Lyme wars

Documents obtained after a long FOIA battle reveal “behind-the-scenes maneuvers and long-standing connections between the scientists’ group and government officials” in the debate over whether Lyme disease can be chronic.

The debate, and the fight for the documents, are detailed by Mary Beth Pfeiffer in the Poughkeepsie (N.Y.) Journal and by documentary film maker Kris Newby on IRE’s Transparency Watch blog.

In 2007, in doing research for a film, Newby requested emails and resumes pertaining to three employees at the Center for Disease Control and Prevention. She writes that “For five years the agency strung me along with frivolous denials, mysterious delays, shifting explanations and false promises. In essence, the delays became an illegal, off-the-books FOIA denial.” Her account of how the CDC handled – or didn’t handle  her request is alarming.

Newby, whose film had been completed, provided the 3,000 pages of documents to Pfeiffer.

The documents show close connections between the government officials who set disease policy and researchers who have received government funds and written treatment guidelines. “As a result, physicians and scientists with opposing views on Lyme disease believe they have been marginalized in the debate.” This graphic provides a good overview of the connections and issues.

Reporters fall prey to back pain study’s shady PR push

Photo by planetc1

If you follow me on Twitter, you may have noticed several 140-character conniptions I had last week over coverage of a Danish study that used antibiotics to treat low back pain.

I generally feel pretty protective of health reporters. I’m in the trenches with you. I have good days and bad days, too. Deadline reporting on medical studies is tough and sometimes undervalued for the work serious, balanced coverage requires. I’m with you.

Even so, I was dismayed by most of the stories I was reading.

Reporters were trumpeting the results of two studies published in the European Spine Journal, a less influential medical journal. Continue reading

Even in treatment guidelines, pharma conflicts abound

As part of the ongoing Milwaukee Journal Sentinel and MedPage Today series “Side Effects” John Fauber and Ellen Gabler “examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the United States” and unearthed yet another tactic by which “pharmaceutical companies, with billions in sales at stake, exert a powerful but often unrecognized influence over the practice of American medicine.”

Issued by leading medical associations and government institutions, treatment guidelines are supposed to be based on rigorous science. But the committees that write them have been dominated by doctors who have worked as paid speakers, consultants or advisers for companies selling the recommended drugs.

In their investigation, the duo found:

  • Nine guidelines were written by panels where more than 80 percent of doctors had financial ties to drug companies.
  • Four panels did not require members to disclose any conflicts of interest. Of the 16 that did, 66 percent of doctors on the panels had ties to drug companies.
  • Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing. Medical experts have raised such questions about guidelines for anemia, chronic pain and asthma.

For extensive anecdotes and examples, dig into the full piece.

U. Iowa hospitals share patient data with fundraising organization

The Des Moines Register‘s Clark Kauffman opens his investigative report with a simple observation: “University of Iowa Hospitals is giving patient names and specific patient-treatment information to a fundraising organization that solicits donations through written appeals signed by physicians.” Then he backs it up.

Kauffman reports that while universities deny that the practice is questionable, “Patient advocates … say the fundraising seeks to take financial advantage of patients who feel indebted to their doctors for their medical treatment.”

“If people actually knew this sort of thing was going on, there would be a significant number of them disturbed by it,” said Dr. Michael Carome of Public Citizen, a national advocacy group with 80,000 members. “The fundamental practice is exploitative … and in my view there is no way to make this work in a way that would be ethical.”

Hospital spokesman Tom Moore said the fundraising campaign is legal and “completely ethical.” He said the university looked at “best practices” among its peers, and its fundraising practices are in line with those of other hospitals.

Kauffman found that, apparently, these “best practices” include sharing patient contact information, insurance status and appointment schedules with donors without their consent. It also includes routinely seeking patient permission to disclose more specific medical information. And the information flows the other way too, with doctors being notified if one of their upcoming patients is a major donor. Kauffman’s piece describes a fascinating hidden economy.

Network drives increase in painkiller prescriptions

In the latest installment of his ongoing investigation for the Milwaukee Journal Sentinel and MedPage Today, John Fauber looks for the source of America’s prescription painkiller boom (graphic), outlining what he describes as “a network of pain organizations, doctors and researchers that pushed for expanded use of the drugs while taking in millions of dollars from the companies that made them.”pills-and-money

Beginning 15 years ago, the network helped create a body of dubious information that can be found in prescribing guidelines, patient literature, position statements, books and doctor education courses, all which favored drugs known as opioid analgesics.

Apparently, that network has been effective. Federal data shows that prescription painkiller sales have quadrupled in the past decade or so, Fauber found, and some of those sales may not have been warranted.

A band of doctors who get little or no money from opioid makers has begun to challenge the hype behind the drugs. They say pharmaceutical industry clout has caused doctors to go overboard in prescribing the drugs, leading to addiction, thousands of overdose deaths each year and other serious complications.

Several of the pain industry’s core beliefs about chronic pain and opioids are not supported by sound research, the Journal Sentinel/MedPage Today investigation found. Among them:

  • The risk of addiction is low in patients with prescriptions.
  • There is no unsafe maximum dose of the drugs.
  • The concept of “pseudoaddiction.”

That concept holds those who display addictive behavior, such as seeking more drugs or higher doses, may not be actual addicts – they are people who need even more opioids to treat their pain.

His investigation dips deep into each of those beliefs and how they helped push painkillers. For a case study, see this companion infographic.