The Burrill Report


Embed your head firmly in sand and repeat after me in your best Dorothy in Oz cadence, “Pens and Pizza and Biscuits. Oh my!”

Now consider this new British Medical Journal commentary piece by Iona Heath, the president, Royal College of General Practitioners. She wrote about attending a meeting about a public health topic that was sponsored by Bristol-Myers Squibb. She was invited by a politician and the invitation and agenda disclosed that "The logistical aspects of this meeting are being supported by Bristol-Myers Squibb (BMS)."

In her commentary, Heath wrote: “The usual round of introductions revealed that there were two representatives of the company in the room listening to everything that was being said … Although I welcome unreservedly the transparent disclosure, when I tried to express concern about the process, the said politician assured me, more than a little abruptly, that it was only the coffee and the biscuits … Not surprisingly, the biscuits were much more tempting than usual … Sadly the politician in question seemed not to be aware of the relevance of any of this to the coffee and biscuits.”

While certainly entitled to her opinion and desire to tow the party line, sadly Heath seems unaware of the evidence to the contrary.

For example, in the January 2010 issue of Academic Medicine, four researchers from the Cleveland Clinic published a study that sought to find evidence of whether industry support of continuing medical education affects perceptions of commercial bias.

The authors analyzed a large, multi-specialty academic medical center’s database of CME activity to determine whether a relationship existed among the degree of perceived bias, the type of CME activity, and the presence or absence of commercial support.

“This large prospective analysis found no evidence that commercial support results in perceived bias in CME activities,” the study concluded. “Bias levels seem quite low for all types of CME activities and is not significantly higher when commercial support is present.”

Further, the American Association of Clinical Endocrinologists and the American College of Endocrinology have adopted a new policy regarding the disclosure of conflicts of interest. It states:

“There is no inherent conflict of interest in the working relationships of physicians with industry and government. Rather, there is a commonality of interest that is healthy, desirable, and beneficial. The collaborative relationship among physicians, government, and industry has resulted in many medical advances and improved health outcomes.”

What a unique perspective—a “commonality” rather than a “conflict” of interest.

In a recent editorial in The Lancet, the journal’s editor, Richard Horton, points out that the battle lines being drawn and between clinician, medical research, and the pharmaceutical industry are artificial at best—and dangerous at worst. They are dangerous, because all three constituencies are working towards the same goal: improved patient outcomes.

His point is that we must dismantle the battlements and embrace the philosophy of “symbiosis not schism.” It’s what’s in the best interest of the patient.

Nature Biotechnology puts it this way: “The great unspoken reality is that relationships between companies and researchers are not only becoming the norm, but they are also essential for medicine to progress.”

Suffice it to say that I disagree with Dr. Heath’s position – but I will certainly defend her right to have an opinion and express it.

Peter J. Pitts, a former FDA Associate Commissioner, is President of the Center for Medicine in the Public Interest


October 03, 2011
http://www.burrillreport.com/article-commonality_vs_conflict.html