|
medpundit |
||
 |
 |
|
Saturday, November 23, 2002Advertising executives note that scientific trials are tightly regulated and that most medical journal articles get careful review. Doctors, they say, are hungry for information about new drugs. But articles don’t get all that much careful review. Too often the review process only serves to make sure the study is well-designed. It doesn’t search for bias. And too often, the editors let the authors inflate their statistically significant findings to make them seem clinically significant, when they clearly aren’t. Heck, sometimes they let them pronounce the statistically insignificant as significant. (By calling it a "trend") This sort of sloppiness is common, and it passes without any sort of editorial comment from the journals. In fact, sometimes the editorials are biased themselves. When Redux was being introduced to the market, the New England Journal of Medicine had an editorial about how its benefits outweighed its risks. Only later did it come to light that the authors of the editorial had financial ties to the makers of Redux. And of course, much later Redux found itself in trouble over fatal side effects. It’s a mistake to think that just because a paper gets published that it’s unbiased, or that it’s conclusions are valid. And it's a mistake to give a paper a pass just because it's published in one of the more prestigious journals. Then there’s the re-writing of review articles to favor a marketing company’s drug, as in the case of Ritalin: The drug company's advisers at Intramed, a medical education company owned by the global ad giant WPP, had a solution. They would take an article, commissioned from two university professors, that objectively surveyed a wide range of drugs and rewrite it to emphasize the potential benefits of a drug with the characteristics of Ritalin LA. The Times article has all the details on this - from transcripts of a conference call between the original authors and the ad agency to an interview with the woman who was hired to ghost write it. Her conscience has motivated her to quit: "I don't have any problem with medical advertising that states in a clear way, either by format or by copy, this is an advertisement," she said. "What I mind is advertising that calls itself education." Right. And here’s another take on the same thing by a former editor of the New England Journal of Medicine: "We don't get anywhere in medicine without objective data," he said. "That's the coin of the realm. The whole purpose of medical research is lost if you don't tell the truth." And don’t think that marketing doesn’t matter. Here’s what it’s done for a new antidepressant, Lexapro, one of those “copy-cat” drugs invented to foil a patent expiration: "Based on the number of prescriptions written in Lexapro's first weeks on the market, the analysts said that Forest appeared on its way to one of the best new product launches in the industry's history. "This market does respond to promotion," Kenneth E. Goodman, Forest's president, said in a conference call with Wall Street analysts on Oct. 15. Forest invested so much in promotion that Lexapro was the subject of 63 percent of all industry-sponsored meetings that primary care doctors reported attending in an October survey by ImpactRx, a consulting firm. Last year, just $2.8 billion of the $11.8 billion the drug industry spent on marketing was aimed at consumers; the rest paid for everything from dinner meetings with doctors to sales calls and medical education, according to Verispan, a health-care information company. That’s a lot of money. Money that could be going to feed research chemists rather than doctors. But, of course, the short term profits of feeding research chemists don’t approach those of feeding doctors. posted by Sydney on 11/23/2002 07:38:00 AM 0 comments 0 Comments: |
|
