#Industry #Sponsored #Doctors

New Study Shows Depth of Commercial Influence

GreenMedInfo LLC

Professional education events are heavily sponsored by drug companies promoting their products as the solution. This widely used coercive and misinformation technique where drug risks are exaggerated and side effects minimized was exposed in a recent BMJ Open study. 

The online medical journal BMJ Open recently published a retrospective cohort study titled Does industry-sponsored education foster overdiagnosis and overtreatment of depression, osteoporosis and over­active bladder syndrome? An Australian cohort study. Looking at publicly reported industry-sponsored events in Australia from October 2011 to September 2015, the researchers focused on three conditions subject to over diagnosis and over treatment: depression, osteoporosis and overactive bladder.

Over the 4-year study period 3,132 events were identified consisting of approximately 96,660 attendees. These events were attended by primary care doctors more often than sponsored events without a focus on the three conditions identified in the study. The researchers found a strong concentration of sponsorship among just a few companies. Two companies sponsored over 70% of depression events; another two companies over 80% of overactive bladder events.

The researchers concluded the following:

"…primary care clinicians were often targeted, dinner was often provided and that a few companies sponsored most events. In most cases, sponsors’ products are not cost-effective choices for the specified condition.” 

The researchers initially hypothesized that company’s marketing treatments for each condition would sponsor related events and that target audiences would mainly work in primary care, reflecting a broad patient population. What they found was in alignment with their hypothesis. The results from the study showed the following:

"Servier, which markets agomelatine and AstraZeneca (quetiapine) sponsored 51.2% and 23.0% of depression events, respectively. Amgen and GlaxoSmithKline, which co-market denosumab, sponsored 49.5% of osteoporosis events and Astellas and Commonwealth Serum Laboratories (CSL) (mirabegron and solifenacin) sponsored 80.5% of overactive bladder events.”

The study highlights the need for professional education to be free of commercial sponsorship. Medical professionals are continually influenced, both directly and indirectly, by pharmaceutical and commercial interests which can have negative, real-world consequences for their patients.

While the recent Australian study highlights the problem of industry-sponsored influence, another more insidious method may be just as alarming. The fraudulent and selective nature of industry-sponsored research often captures the intellectual and regulatory pillars of medicine. For example, in 2015 the BMJ published Restoring Study 329, a decade-long effort by researchers to uncover the truth about the health risks and treatment value of an antidepressant approved for use by adolescents. Using the same data GlaxoSmithKline used to market their blockbuster antidepressant Paxil, researchers doing the restorative study 14 years later found that,

“Neither paroxetine nor high-dose imipramine demonstrated efficacy for major depression in adolescents, and there was an increase in harms with both drugs.”

Meanwhile, a 2012 Cochrane systematic review found that AstraZeneca’s antipsychotic quetiapine, highlighted in the recent BMJ Australian study, had limited efficacy evidence for depression.

Industry influence upon the knowledge base, prescribing habits and beliefs of medical professionals often renders natural remedies and true healing solutions to depression, osteoporosis and overactive bladder invisible. Modalities with less potential for serious side effects too often become the casualties with the net effect seeing the patient shouldering the burdens of risk and substandard results.

How bad can it get? A look back at the past twenty-years reveals a cautionary tale of a racing American opioid epidemic caused in part by the combination of both industry-sponsored education and fraudulent research.

Dr. David Kessler, U.S. Food and Drug Administration (FDA) commissioner when Purdue Pharma’s opioid OxyContin, the drug that kicked off the American epidemic, won the agency’s green light in 1995 acknowledged,

“No doubt it was a mistake. It was certainly one of the worst medical mistakes, a major mistake.”

It was the first opioid to win the stamp of approval from the FDA, despite the lack of testing and demonstrated proof of the drugs safety and efficacy. Purdue then went on to sent a promotional videoto approximately 15,000 doctors who were told OxyContin was “less than 1 percent addictive” — a figure subsequent studies proved false.

Once the overwhelming evidence of devastation from the opioid crisis began to be spotlighted by the media, then-president Richard Sackler of Purdue wrote in a confidential email,

“…we have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals.”

Established medicine appears to be at the beginning stages of confronting its industry-sponsored blindspots. As more in the profession began escaping their myopic pharmaceutical shackles in search of true healing, it is essential for patients to empower themselves alongside this awakening become active participants in their individual healing journeys. Please use the GreenMedInfo research dashboard to access over 10,000+ evidence-based topics related to natural and integrative medicine. And share the resource, and this article and others to friends and family, who can subscribe to our complimentary newsletter here.