A new scientific study published by the British Medical journal has highlighted a conflict of interest existing between the pharmaceutical industry and doctors which aim at preventing doctors from reporting side effect of medicines.
Could the remuneration given to doctors possibly influence their judgement regarding side effect?
Post marketing studies allow pharmaceutical companies to test the efficacity and success of their medicines based on doctors's opinion. This pratice has been largely criticised for being nothing more than “marketing masquerading as research", meaning research which purpose are solely commercial motives, not scientific ones. Futhermore, the confidenticiality clauses signed by both parties prevents physicians from reporting side effect to health authorities.
Before being put on the market, drugs have to go through battery of tests done by the health authorities and specialized institutions. After being put to sale, pharmaceutical companies record the sales and the efficacy of the medicine in real conditions. In order to collect relevant data, they ask doctors to report any eventual side effect of those medicines. This seems like a well thought system... in theory. Only, uncertainty exists about whether the amount of the remuneration received by physicians could biased their judgement.
German pharmacovigilance put aside by laboratories
the recent study published on the British Medical Journal are based on the observation of 558 post marketing studies done in Germany. The average earning per participating physicians per study was 19 424 euros (the highest remuneration documented by this study being 2 million of euros), which is about 441 euros per patient tested. Among those 558 studies, no cases of drug's side effect was reported to the German pharmacovigilance. While it could only be a coicidence the questions remains: Are doctors influence by the amount of their remuneration? Is there a possibility of them being removed from the studies should they report on side effects ?
Impartial institution: a solution?
The authors of the article highlight the ambiguity of the confidentiality clauses signed by the physicians which prevent them from reporting any side effect to health authorities and make it mandatory for them to report only to the laboratory itself. Wouldn't it be more pertinent to instaure an impartial institution between the doctors and the laboratories, for safety and objectivity's sake ?
Sources: British Medical Journal, Multinational's observatory