'No one knows the total amount provided by drug companies to physicians, but I estimate from the annual reports of the top 9 US drug companies that it comes to tens of billions of dollars a year. By such means, the pharmaceutical industry has gained enormous control over how doctors evaluate and use its own products. Its extensive ties to physicians, particularly senior faculty at prestigious medical schools, affect the results of research, the way medicine is practiced, and even the definition of what constitutes a disease'.Consider Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital.
'Thanks largely to him, children as young as 2 years old are being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many not approved by the FDA for that purpose and none of which were approved for children below 10 years of age.
Legally, physicians may use drugs that have already been approved for a particular purpose for any other purpose they choose, but such use should be based on good published scientific evidence. That seems not to be the case here. Biederman's own studies of the drugs he advocates to treat childhood bipolar disorder were, as The New York Times summarized, "so small and loosely designed that they were largely inconclusive."
In June, Senator Grassley revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. Two of his colleagues received similar amounts'.In an interesting twist after this was revealled the president of the Massachusetts General Hospital and the chairman of its physician organization sent a letter to the hospital's physicians expressing not shock over the enormity of the conflicts of interest, but sympathy for the beneficiaries! "We know this is an incredibly painful time for these doctors and their families, and our hearts go out to them."'
The conflicts of interest here are clear enough for prescribing doctors and pharmaceutical regulators to appreciate.
Update: This article in NYT records that US pharmos have agreed to stop issue branded trinkets - Vioxx pens and so on. Quote:
“We have arrived at a point in the history of medicine in America where doctors have deep, deep financial ties with the drug makers and marketers,” said Allan Coukell, the director of policy for the Prescription Project, a nonprofit group in Boston working to promote evidence-based medicine. “Financial entanglements at all the levels have the potential to influence prescribing in a way that is not good.”