Our fellow WordPress.com blogger, James Ridgeway, has been looking into the fuzzy boundaries that exist between pharmaceutical companies and psychiatry. See his reporting here.
The reporting by James prompted me to look into this matter more extensively. In the spirit of full disclosure, I have been to trainings put on by pharmaceutical companies in backwater places like Orlando, Florida [where one could presumably bring along the family to do the Disney Experience while you, the participant, toiled away]. These trainings were held in hotels where they asked $30 for a glass of wine and I couldn’t detect that they felt any shame in doing so. Though wine wasn’t supplied, many a not too cheap meal, and lavish hotel rooms were provided by the international pharmaceutical giant whom I won’t name.
In his section of a debate in the aptly titled article, “Is academic psychiatry for sale?”, David Healy covers the history of how pharmaceutical companies came to have such major influence over the activities of psychiatrists in academic settings ( Healy & Thase, 2003). Three trends beginning in the 1970’s led to the fuzzy boundaries that exist between academic psychiatry and Big Pharma. The first was a restructuring within pharmaceutical companies whereby marketing and sales departments were separated. This in turn led to the emerging of contract research organizations which replaced universities as the organizers of clinical trials. Also appearing at about this same time were medical writing agencies, who now write the first and often subsequent drafts of research reports. Senior academics make superficial instead of meaningful contributions to these research reports that bear their names and formerly good reputations.
Standing in the way of empiricism and “real science” is the fact that Big Pharma companies consider the data they collect as proprietary. Clinicians are only given small subsets of data. This “research” has the appearance of “real” research, and it gets published into prestigious journals. But as Healy states: “It certainly has the appearance of science, but it is a cuckoo’s egg in the nest of science” (Healy & Thase, 2003, p. 389).
Healy summarizes the sorry state of affairs by concluding:
At present, journal editors seem to be the fall guys who, equipped with the shovels of conflict of interest statements and the brooms of authorship declarations, are expected to clean out the Augean stables of an increasingly compromised academic literature, when what is need is a breach in the dam of academic silence and a flood of refusals to accept that publications that involve data that are not publicly available should be called scientific. A failure to take a stand will leave us repeatedly cuckolded by every issue of our major journals (Healy & Thase, 2003, p. 389).
Healy, D., & Thase, M.E. (2003). Is academic psychiatry for sale? British Journal of Psychiatry, 182, 388 – 390.
Just as an ending note, meta-analytic reviews have consistently shown that those studies sponsored by pharmaceutical companies report a larger effect size (greater effectiveness) for the drugs they produce than those studies which are not sponsored by pharmaceutical companies that made the drug under investigation. This finding holds even when double blind conditions are in effect (which are supposed to limit the apparent bias that looks to be creeping into these results). Makes ya go, “Hmmmmm???”