The powerful National Academies of Science in the United States released a report this week, calling for much greater distance between doctors and drug companies.

The report, written by the National Academies’ widely respected Institute of Medicine (IOM) — which advises America on health matters — calls for a ban on doctors accepting any gifts or meals from drug companies, a move which would have major changes for the diets of many medicos.

In Australia, according to figures from the drug industry, doctors, pharmacists and nurses are provided with free meals by drug companies at more than 30,000 events annually, many of them in fancy restaurants and at flash resorts.

The report calls on the United States congress to make laws requiring drug and biotech companies to disclose every single payment to every doctor, medical association, patient advocacy group and educational provider.

US Congress is currently considering the Sunshine Act, which would force companies to disclose some payments, but the new IOM report calls for more comprehensive disclosure.

The authors write that collaborations between doctors and drug and device makers can benefit society through discovery and development of new treatments, but financial ties “present the risk of undue influence” on doctors’ judgments and may “jeopardise” scientific integrity, patient care, public trust and the “objectivity of medical education”.

With doctors’ education, the IOM report urges the development of “a new system for funding high-quality accredited continuing medical education that is free of industry influence.” Significantly it also recommends clinical guidelines — which can carry great influence over what doctors to their patients — should not be funded by industry and that doctors with ties to industry should be excluded from the panels who write guidelines.

The tough calls come at a time of continuing controversy in Australia about drug company connections with the development and promotion of blood clot guidelines, and a recent deal between a leading medical research organization and a drug company — both of which are being actively debated at Croakey.

Despite their closeness, doctors and drug companies are becoming increasingly uneasy bedfellows, with calls from the very top of the global medical profession for a major clean up.

A group of influential doctors writing in the Journal of the American Medical Association this month called for medical associations, to “work toward a complete ban on pharmaceutical and medical device industry funding ($0)” for their general budgets, although journal advertising and exhibit hall fees were acceptable. And like this week’s IOM report, the group suggested panels that write guidelines simply exclude doctors “with any conflict of interest ($0 threshold)”.

The new recommendations should give much food for thought, to medical groups in Australia currently debating their relationship with industry sponsors.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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