The Conflict of Interest talk these days is all about doctors and medical school lecturers who are in bed with Big Pharma, but the bed is pretty crowded. Researchers are there, too. Not that this hasn't been a topic of conversation. And not that researchers aren't conscious of it and frantically trying to distance themselves from it. But it's nice and warm under the covers and its a friendship with benefits, as the younger generation likes to put it:
As accusations of undisclosed financial conflicts among university researchers swirl, drug makers and academics are entering a new stage of closer collaboration. Instead of striking traditional licensing deals with academic labs that produce commercializable results, companies are starting to reach farther back, all the way to the inception of basic research projects.
The motivation from both sides is obvious: Pharma has a pipeline problem, and universities are clamoring for research dollars as public funding feels the pinch of the deflating economy. But closer relationships and earlier-stage collaborations between academia and pharma companies do not come without potential conflict of interest issues of their own. (Bob Grant, The Scientist)
The issue from Pharma's side is clear: they have a "pipeline" problem, which is to say they have few new (obscenely profitable) drugs in the pipeline. That's because they really don't do much original research on their own, regardless of the line they feed the public and their bought-and-paid-for politicians that basic "research" looking for cures for cancer is very expensive. They don't do that kind of research. They let academia do it, bought and paid for (there's that phrase again) by the US taxpayer via NIH. But they still want exclusive access to it and they also want to control its direction. They aren't interested in the free and unfettered search for truth which often pays the unexpected but handsome dividend of being tremendously useful. They want the controlled and fettered search for new drugs. So they buy in to the research enterprise:
About a year ago, Merck Research Laboratories created a formal department to actively seek out early stage research collaborations with external partners. Catherine Strader, vice president of that department, called external basic research, said that Merck plans to draw at least 25% of its early pipeline over the next five years from deals with academic labs, as well as small pharmaceutical and biotech companies.
Merck isn't the only one. Well-developed products or technologies that could be licensed by pharma companies are rare these days, said Pfizer spokesperson Ed Bryant, adding that increased competition and licensing costs have driven pharmaceutical companies to consider a different strategy. "We had to shift to develop collaborations with talented academic groups to generate intellectual property earlier on."
Yes, intellectual property. Patents and licenses giving exclusive rights. They are buying it and getting it cheaply because they are parasitizing the basic research enterprise paid for by taxpayers. In all the talk about the freedom to publish and conflicts of interest by university committees, this doesn't seem to come up. It seems to be taken for granted that if a drug company supports research to the tune of a few tens of millions (chicken feed in marketing budget terms) this gives them an exclusive right to market the product. The taxpayer? No such right. Just the right to get fleeced.
It's a sweet deal for Big Pharma. They go through the motions of making agreements about "academic independence" and other matters of genuine concern to scientists and get in return scientific talent working on problems of interest to them (and often diverted from things that might be problematic). And they get early access, sometimes delayed publication to complete the patent process, and intellectual property rights for which they provided very little, if any, intellectual input. And they get it for a pittance.
Meanwhile the researchers are happy and content. So are high class hookers and gigolos.
First day in my child psychiatry postdoc, the barrage began. Two physicians tried to push rx into my hands. "What is this?", I asked. "Zanax -- we're all on it. Take it. You'll feel better." "Why? I feel quite well, actually . . ." Wrong answer.
Then I started learning how to dose children with serious psychopharm, and at serious levels. Most of my fellow PGYs did not know anything about child development, nor did they care to learn. All you you needed to know what which rx to push. Differential diagnoses were slanted to the dx that indicated an rx. Research was only conducted on dosable dx -- and with all of the other willful behavior going on, I always wondered how the data fared. NIH RFPs were know before they were made public, so that the good ol' rx company connected boys could submit well-prepared proposals. The only good thing I can say is that they drew the line at putting infants on meds -- a line that a few years later is routinely brushed aside.
Contests were run in the hospital on how many patients a doc could see in an hour. Two- to three-minute med checks could yield 20 patient billings per hour -- if you had good office staff to hustle them in, hustle them out. Teas and cocktail parties? The chiefs told me what meds they were on, and asked me what I was on. I would reply, "I could do with some aspirin." Fellows offered to write script if I would give half back, got annoyed that I refused to 'share'. There must have been a good local street value for what they were pushing.
One of the fellows arranged to treat a very cute and charming 11-year old boy, so she could, in her professional term, "do him." I was told, mind your own business, she can say what she wants, did you see the act? No? Then nothing happened. Forget it. They were right, she wasn't an exhibitionist. Apparently that would have been a violation.
In the muck with these hucksters, were a few very dedicated and capable physicians -- I dodn't know how they managed to stay sane with the others taking a crowbar to the patients and their profession -- and pocketing easy money.
Imagine if research showed that type II diabetes could be cured in it's early stages with a single injection of insulin. My wifes Doctor in Taiwan said their research has showed to be true. Taiwan has a government run universal health insurance program so have an incentive to reduce costs.
I am not saying it is true, since I do not know, but this
would not be good news for Big Pharma, so I doubt this research would be funded by government if Big Pharma can direct the funding. There are many other examples where you can imagine a cure not being in the best interest of those who profit from drugs that must be taken for years to treat the disease.
And do you really think government wants more people collecting social security and medicare until they reach 95. Might be better if they kicked off at 60, hence the resistance to single payer health care. Ya think?
I'll add that single injection theory to the pile where "they" are keeping the water powered car.
During my four years of research into the conflicts of interest in Lyme disease, it became pretty clear that one of the premier escort services in matching up willing academic researchers with pharmaceutical companies in need of govât grants for drug discovery, is the Infectious Diseases Society of America (IDSA).
IDSA/Pharma's vehicle for getting their new drugs into insurance formularies is through the writing of "evidence-based" medical guidelines. The IDSA has 51 guidelines posted, and researchers who write them are unpaid and protected from individual lawsuits. In return, the academic researchers get first dibs on lucrative clinical drug trials and patent royalties on new drug discoveries. This is soft money with lots of hidden connections and long lead times, which are often not reported in the financial disclosures at the end of journal articles.