Sophie Black writes:

One of Australia’s most
senior cancer specialists hasrevealed to The Age
that pharmaceutical companies manipulate clinical trials of
medicines for commercial reasons, but doctors have told Crikey that
this is hardly news. The CEO of Therapeutic Guidelines told Crikey that
since drug research is left to an
industry that places commercial interests over patients’ interests,
there’s bound to be holes in study
results to suit big pharma’s PR purposes.

The drug industry behaves like any
other profit driven industry so “they design the trials to produce the answers that
they
want…” Mary Hemming, Chief Executive Officer of non-profit organisation Therapeutic Guidelines told Crikey this morning. Industry
pays for most of these trials, “therefore
they’re in the position to design the trials and set the agenda.”

The problem is a lack of government funding –
“government provides a lot of money into research but not
into research for drug therapy,” says Hemming. “Because industry
is there willing and wanting to fund it
because they have control over it…” the government lets them pick up
the slack and spend the money. But that means “questions that should be
researched aren’t
because there’s no commercial incentive.”

“Public health departments have to cover their backs by making
decisions based on evidence,” says Hemming, “but if that evidence is
only coming from industry” then obviously they’re not getting the whole
picture. “No-one is shining the light on areas that could be extremely
valuable because there’s no commercial incentive…”

And as for the doctor’s part in the equation,
child psychiatrist and Healthy Skepticism Chair Dr Jon Jureidini explained the “mutual massage”
process to Crikey, “I was approached a number of years ago by a
pharmaceutical company asking me to be a chief investigator in a study
of an
antidepressant… if I’d agreed to do it they would have paid an amount of
money per patient that I recommended to cover the cost to the unit of
running a trial… that money would have gone to some sort of hospital trust, but it would
have been an
advantage to the department.”

“I would have got
my name on a publication without doing much work and lots
of contact with a group of like minded, drug minded psychiatrists. …It
also would
have involved a meeting in some faraway place to be consulted about the
design of the study and then I might have been invited to take up some
other kind of role within the company as an
advisor… The ideal outcome is that I become a key opinion leader… that
in turn would help me
to get publications…And
then if it all goes well I become a speaker on their circuit, I’m an
author on
a number of ghost written papers.”

“The companies often appeal to their egos,” agrees Hemming, “it’s not
necessarily the amount of money…it’s about being made to feel important.”

And until the government starts throwing money at independent clinical trials, the massage sessions are set to continue.