An interview with Ray Moynihan

Study finds medical panellists have links to pharmaceutical industry

TONY EASTLEY: A study of the people who make up the expert US disease panels, which make changes to the definitions and diagnostic factors of common conditions, has found that 75 per cent of them have links to major medical and pharmaceutical companies. 

The panel members make recommendations on conditions like hypertension, cholesterol, Alzheimer's disease and rheumatoid arthritis. These recommendations can lead to more preventative medication being prescribed. 

The study's lead author is with a Queensland university. He's told AM that while he doesn't think individual panel members are swayed by their industry links, it's clear there is too much conflict of interest.

Tom Nightingale reports.

TOM NIGHTINGALE: The top medical panels in the US have a massive influence on what happens elsewhere, including in Australia. But Bond University's Ray Moynihan says those panels are tainted.

RAY MOYNIHAN: We're not talking about individuals acting corruptly. We're talking about a sense of systemic corruption.

TOM NIGHTINGALE: He's the lead author of a study that has found three in every four panel members disclosed a link with a company, like an advisory or a research role. Of those, the average panel member disclosed seven industry links.

RAY MOYNIHAN: We're talking about the extensive nature of entanglement between the pharmaceutical industry and the medical profession being out of control. And the most senior pillars of the medical establishment are acknowledging that that entanglement is far too widespread. 

And there are strong calls repeatedly from the leaders of the medical establishment to start trying to wind back the extent of that entanglement, because these financial interests, these financial ties, have the potential to subtly distort professional judgement. 

TOM NIGHTINGALE: Ray Moynihan says the research is the first in the world studying the work of expert panels for multiple diseases. 

But it's not unusual for top medical brains to have links with major companies. Dr Steve Hambleton is the president of the Australian Medical Association. 

STEVE HAMBLETON: Well I think that the key researchers that are doing this work will, most often will have pharmaceutical company links. 

The top researchers are not the clinicians out in the community that are relying on that research. They're people working in universities, they're participating in those phase two and phase three trials.

TOM NIGHTINGALE: But why though, if we take the case of a university researcher, why would someone in that position be likely to have a link with a drug company? Why is that so common?

STEVE HAMBLETON: Well it's so common because the big funding that's required when a new drug comes to market will often come from that pharmaceutical company investing in its drug to see whether it actually works.

TOM NIGHTINGALE: The study included 10 panel papers that resulted in broader disease definitions. Ray Moynihan says none appeared to examine the potential harm in doing so. 

RAY MOYNIHAN: What we've seen is something of a pattern of disease definitions being broadened, potentially broadened too far, so that people with milder symptoms or at lower risks are being labelled and treated, potentially doing them more harm than good. 

TOM NIGHTINGALE: But Dr Hambleton says changes are made legitimately.

RAY MOYNIHAN: So all these things are useful for the population, useful for doctors to help their patients make decisions about their care. 

TOM NIGHTINGALE: The study is being published today in the Public Library of Science Medicine journal. 

TONY EASTLEY: Tom Nightingale.

http://www.abc.net.au/am/content/2013/s3825033.htm