Conflict of Interest Posted by Meg at 07/16/07 07:10 PM

Doctors with Drug Ties Chosen for Avandia Panel

In two weeks, an FDA advisory panel will meet to discuss the safety of the drug Avandia - a diabetes drug which, according to recent studies, may increase the risk of heart attack by 43%. Amongst the members of the panel will be six doctors who have financial ties to the pharmaceutical industry.

It’s not as if this is a new phenomenon – in fact, just the opposite. A study last year by the Journal of American Medicine revealed

“…the extent to which panel members were receiving support from the very companies whose drugs they were voting on — a clear conflict of interest. The report found that in meetings held by 16 advisory panels between 2001 and 2004, at least one panel member had a conflict in 73 percent of meetings. And here's an even more shocking indictment: In 22 percent of the meetings examined in the JAMA study, more than half of the individual panel members at those meetings had a conflict of interest.” Yahoo Health News

The newly-appointed Avandia panel members are merely the latest in a long line of panel members who have had ties to the industry, including those that made decisions about medicated heart stents, Celebrex, Bextra and Vioxx. (A 2005 panel on those three drugs voted to keep them all on the market – even after two of them had been pulled for increased risk of heart problems and strokes.).

When questioned, doctors insist that financial ties to pharmaceutical companies don’t influence their votes, including several who will be sitting on the Avandia panel. However, an analysis of the Celebrex/Bextra/Vioxx panel votes showed just the opposite:

Of the 30 votes cast by the 10 panel members [who had relationships with the drug companies] on whether Celebrex, Bextra and Vioxx should continue to be sold, 28 favored the drugs. Among the 66 votes cast by the remaining 22 members of the panel [without conflicts of interest], just 37 favored the drugs. The members with financial ties to the companies were 10 times more likely to favor the drugs as those without such ties. San Francisco Chronicle

In that case, I agree wholeheartedly with Merrill Goozner:

"They shouldn't appoint people with conflicts of interest,'' said Merrill Goozner, the director of the Integrity in Science project at the Washington-based Center for Science in Public Interest, in an interview. "The public perception of the evenhandedness of the process will be immeasurably enhanced if they appoint only people who do not have conflicts.''

Recent drug safety legislation that passed the House of Representatives addresses the issue by limiting the FDA to grant only one conflict of interest waiver per advisory panel. Experts with conflicts of interest without waivers could present information to the panels, but are not allowed to vote. Let’s hope that the final draft of the bill that goes to President Bush for signing maintains this strong language and starts us on a new path of un-conflicted advice from our country’s medical experts.

comments (1)

1 Posted by jazzyB at 08/11/07 08:20 AM

Avandia was heavily advertised to black physicians and the company spend an enormous amount of money influencing this group with advertisements and support for the National Medical Association. The National Medical Association (NMA) has strong ties to the
pharmaceutical industry with approximately 85% of all funding coming
from this industry. The NMA has approximately 1,100-1,700 paid
physician members with a large portion of them being resident
physicians and medical students although in its promotional materials
it cites over 25,000 members. The membership of the NMA has never
exceeded 3,000 physicians in any given year further a large portion
of
their members are retired physicians. Many critics believe that the
NMA is simply a front for the pharmaceutical industry and given its
stance on several issues that the pharmaceutical industry lobbyists
promote, this is a valid criticism. There is a direct link with the
NMA's position statements and policy and the major funders of the
organization (drug companies). Further, the NMA hosts a "health
policy
colloquim" each year that is soley and fully funded by Pfizer Inc.
The
organization uses this time to invite politicians, healthcare leaders
and physicians to talk about the health policy in the United States,
again this is fully funded, supported and attended by Pfizer Inc.
which leads many to question the credibility of the organization.
The NMA hosts a national conference each year that is attended by a
few thousand (approximately 1,000 physicians and the remainder are
spouses and families). This conference is usually held in a major US
City with Honolulu, Hawaii being the most frequented venue. In 2007
the NMA went back to Hawaii with every major pharmaceutical company
in
the United States in tow-- supporting the event financially. Indeed,
physicians are unashamedly wined and dined by drug companies, attend
lectures on medications and treatment regimens that are funded by the
pharmaceutical industry and are able to receive many perks from the
industry. This conference, a tax deductible family vacation, is the
major fundraiser for the organization. Additionally, the NMA has a
"journal" which is fully supported by the pharmaceutical industry and
is another profit center with "medical articles" that appear which
are
heavily weighted pro-industry.

The NMA offers little to no outreach to patients or support for
physicians that take care of patients. Any outreach that it does
extend is fully funded by the pharmaceutical industry or the US
government with a hefty portion retained by the organization to stay
afloat. The organization often exploits its history of being the
oldest organization of Black physicians to blackmail pharmaceutical
companies and in some cases the government for funding. However, the
NMA is not the largest organization of minority physicians-- the
American Medical Association's Minority Affairs Consortium (MAC)
actually dwarfs the NMA membership and incidentially has little to no
funding from the pharmaceutical industry. The NMA further exploits
its
history and misrepresentation of actual membership in efforts to
promote the recycled leaders. The "elected" leadership often consists
of the same persons in various positions and the organization is
fraught with political corruption, questionable elections and poor
policies. Additionally, financial audits have been troubling for the
organization and it refuses to release fully audited statements from
the last 20 years with only selective years being released. The NMA
has been sued by several employees-- all settled out of court to the
benefit of the former employee and has years of questionable employee
policies. This while remaining a tax exempt organization and when
challenged playing the "race" card and comparing itself to the
American Medical Association.

This is the NMA--- dig deeper and it just gets worse. Unfortunately
as
a former employee-- I know this organization too well. The NMA is a
sham, a front for the pharmaceutical industry and a diservice to the
nation.