A recent article in the Chronicle of Higher Education focuses on an Ex-Merck Spokesman Pointing the Finger at Paid Consultants in Drug Lawsuits. The issue was discussed following an 11-page essay by Laurence J. Hirsch, a former spokesman for the pharmaceutical maker Merck & Company, which was published by the journal Mayo Clinic Proceedings, along with a supporting editorial by William L. Lanier, the publication's editor in chief.
Specifically, Drs. Hirsch and Lanier posed the question whether “journals also see a financial conflict when the researchers are being paid to help warn consumers against buying a potentially unsafe drug or medical device?”
“As examples, Dr. Hirsch cites Harlan M. Krumholz, a Yale University professor of medicine, who has collected some $200,000 while working on behalf of plaintiffs suing Merck, and David S. Egilman, a clinical associate professor of family medicine at Brown University, whose court testimony has brought him more than $2-million.”
Dr. Hirsch asserted in his article that “medical journals should be just as wary of Drs. Krumholz and Egilman as they are of company-paid researchers.” He further asserted that "It strains credulity that such consultants can be objective in depicting the behavior of the defendant they are being paid to help plaintiffs' attorneys sue," he said. As a result, industry representatives applauded Dr. Hirsch’s assertion.
For example, Ronald Rogers, a current spokesman for Merck noted that financial biases do not only come from industry expense accounts. He further asserted that Dr. Hirsch’s article correctly pointed out that "The pharmaceutical industry is being held to a higher standard than other groups.”
In response to Dr. Hirsch’s claims, Dr. Krumholz and Joseph S. Ross, an assistant professor of medicine at Mount Sinai School of Medicine also cited by Dr. Hirsch, claimed that his article did “not present any evidence beyond hearsay to support his assertions or contradict our findings." Interestingly, proponents of industry funded research usually assert the same thing: there is no evidence that industry support biases the outcome of research, articles or presentations. So who do we believe more, those who step on the stand and are specifically advocating one position, or those in the labs testing out science?
Other ‘comebacks’ that Dr. Hirsch’s article was biased were easily disputed by Dr. Lanier who noted that the article “makes clear Dr. Hirsch's past and present ties to Merck, and saying the publisher has no control whatsoever over editorial content.” Instead, Dr. Lanier noted that other “leading medical journals have consistently shown an anti-business bias that eventually will stifle the "creativity and productivity" of U.S. companies and force research and development abroad.”
As a result, Dr. Lanier hopes that “Dr. Hirsch's article would make fellow medical journals more skeptical of the financial motives of all authors,” because “tougher conflict-of-interest rules might just give honest researchers more paperwork and simply prompt any less-than-honest researchers to work harder to find loopholes.”
Accordingly, holding the pharmaceutical industry to a higher standard than expert witnesses called by attorneys is problematic. Looking at the whole picture, paying someone to advocate a certain position for an intended outcome has the potential for bias. When doing so involves convincing 12 people, the chance for influence is more subjective whereas, trying to convince science is largely based in the facts.
By shedding some light on the alternative perspective of conflicts, Dr. Hirsch’s article serves as an example that while everyone has an interest, and some have the potential for conflict. Why are plaintiff physicians being treated differently than clinicians and researchers?
Drs. Krumholz, Egilman et al. have been disclosing. What is the evidence that they are being treated differently?
Posted by: Marilyn Mann | December 16, 2009 at 11:43 AM