![]() ![]() In 2003, a systemic review of 30 studies comparing outcomes of industry-sponsored with non-industry-sponsored trials found that, overall, studies funded by a company were four-times more likely to have a favourable result compared to studies funded from elsewhere. Every trial demonstrated that the company’s drug was superior or as good as the control treatment. A favourable trial is worth thousands of pages of advertising for a drug company and that’s the reason it is prepared to spend as much as a million dollars to purchase reprints that may be distributed globally.Ī study of manufacturers-supported trials of non-steroidal anti-inflammatory drugs in the treatment of arthritis, published in the Archives of Internal Medicine in 1994, found that not a single trial published negative results out of a total of 56 examined. A large trial published in a leading medical journal will be distributed around the world and may often be covered by the international media. Readers are deeply influenced by these randomised controlled trials, which they believe are the acme of scientific rigour and evidence. Moreover, as in every sphere, the public is aware that an advertisement is a larger than life sales pitch.Ī larger problem is the publication of clinical trials by medical journals. The advertisements may be misleading (with profits worth millions) but they are visible for all to see and criticise. In an excellent article, published in the journal PLOS Medicine in 2005, Richard Smith says that although a substantial income is earned by medical journals printing advertisements, it is still the least corrupting form of dependence. Richard Smith, former editor of the British Medical Journal (BMJ) noted that Jerry Kassirer, another former editor of the NEJM, had argued that the drug industry has deflected the moral compass of many physicians. ![]() I was compelled to rub matters in by quoting Richard Horton, editor of The Lancet : “Journals have devolved into information laundering operations for the pharmaceutical industry.” In the same year (2004) Marcia Angell, former editor of the NEJM, criticised the industry for transforming into “primarily a marketing machine” and co-opting “every institution that might stand in its way”. There was stunned silence when I mentioned the New England Journal of Medicine (NEJM) as one of the leading culprits publishing manipulated data because the NEJM is considered by most to be the holy grail of medical journals. The derision and hostility of the audience was palpable when, at a recent cardiology conference in Delhi, I stated that substantial data published in the leading medical journals of the world not only exaggerated drug effects but could also be considered misleading. ![]()
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