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No need to be so precious about conflicts of interest…the discussion continues

Continuing recent discussions at this blog about the sponsorship deal between Medicines Australia and The Australian and broader concerns around relationships between pharma and media…

Ron Batagol, pharmacy and drug information consultant, writes:

For the sake of logical and argumentative consistency, I will again be the devil’s advocate in this discussion of, what is in reality, a broader consideration of the concept of conflict of interests, than just those issues confined to the drug industry and its connections with health professionals and more recently journalists.

As I’ve written previously, I deplore and am very critical of, drug company sponsorship WITH AN INFLUENCE ON CONTENT of publications, research, or so-called “educational lectures “ by a “peer group leader” relating to a new drug or new use of a drug, as well as the mindless exercises of stage-managed sponsored “advertorials”.

However, as I also previously discussed, if the objection to privately-funded health journalism, or privately-funded University Chairs to carry out important socially-desirable research into otherwise unattractive and neglected research, is based on the appearance as well as the reality, of potentially influencing critical and objective review, then, logically, we also have to object to “opinion leaders” being used on government advisory committees.

When I raised this previously, Croakey stated that “clearly these are contentious issues, and the subject of regular debate in the research literature as well as the mainstream press”, then immediately segued to concerns about “academic articles investigating pharma marketing and COI-related issues”, which was NOT the issue that I raised.

Just one illustration of the point I was trying to make. Why do we hear little or no comment (apart from, whatever else is their agenda, the AMA, to their credit,) on the major clinical concern that e-Health records in the future, which have been “cherry-picked” by the patient, may lack vital health information, in an emergency care situation, thereby compromising or endangering patient health?

Could the lack of criticism be that, if they become too critical and “hard to work with”, major professional and other health groups may be left out of having an influence on the advisory group processes feeding into this major Government project from which in the end all will benefit?

Or do we really think that the frailties of human behaviour on conflict of interest matters are restricted to issues emanating from the commercial world?

And, no, I don’t think health professionals and their organisations should opt out of offering their expertise by assisting in setting up new and innovative medical and health developments (heavens knows the way this Government implements their various policies, they need all the help they can get!).

Nor do I think that health opinion leaders should boycott government advisory committees, or not be reimbursed for their time for doing so.

So therefore, in the end, much as we would wish otherwise, the real world is not perfect, and I would contend that there is nothing wrong with a commercial organisation using its resources to contribute and support health and medical discussion and research, which may not otherwise be funded, as long as the content is absolutely controlled by the authors, lecturers or researchers.

If we achieve all that, does it really matter if the commercial organisation gets an improvement in their public image in the process?

For instance, I don’t hear too many objections to the sort of work that the Bill and Melinda Gates Foundation carries out around the world, much of which would not otherwise be done. (BTW their Conflict of Interest Policy may be an excellent template for medical researchers and medical journalists to follow).

The alternative is that, be being too precious and pure, we may miss out of the real potential benefits of private-public partnership in funding and helping to resource otherwise unattractive educational and public health projects.

***

For recent related articles:

• COI concerns overblown says Medicines Australia

• Doing the dance: pharma and journalism

• Potential pitfalls of deals between pharma and media

• Pharma industry is also distributing The Australian’s health series

Concerns raised about pharma-sponsored health journalism and the Crikey story

• Adam Cresswell’s response

• This is no small matter

• Meanwhile, this post from last year has some other relevant background regarding media and medical conflicts of interest.

 

 

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