Doctors Without Borders

DOCTORS WITHOUT BORDERS….Are the pharmaceutical studies published in leading medical journals truly the products of dispassionate science? Ask Betty Dong:

Betty J. Dong, a pharmacologist, had been contracted in 1987 by Flint Laboratories to run a clinical trial comparing Synthroid, Flint’s synthetic version of thyroid hormone, to that of three competing formulations. At the time, Synthroid was the market leader and the most expensive drug in its class. Dong and Flint signed a lengthy agreement detailing the design of the study, and both sides fully expected the results would show that Synthroid was superior.

But all four drugs turned out to be essentially equivalent. In 1990, as Dong prepared a paper for JAMA, the company that was at first so eager to solicit her help, launched a vigorous campaign to discredit the study. Flint then rushed its own paper into press at a less prestigious journal, concluding–surprise!–that Synthroid was superior. After numerous attempts to address the company’s criticisms, Dong finally submitted her paper to JAMA, only to withdraw it three months later when the firm threatened to sue for breach of contract. It took the FDA and U.S. Department of Health and Human Services to get the company to back down. Dong’s paper did not see print in JAMA until 1997.

….In a recent survey of clinical researchers, nearly 20 percent of respondents admitted to delaying publication of their results by more than six months at least once in the last three years to allow for patent application, protect their scientific lead, or to slow the dissemination of results that would hurt sales of their sponsor’s product.

This is from “Doctors Without Borders,” by Shannon Brownlee, published in the April 2004 issue of the Washington Monthly. It’s a terrific look at the increasingly corrosive effect of industry sponsorship on medical research, a topic that’s gotten a lot of attention ? and prompted new federal guidelines in the process ? in the year since Shannon’s article appeared.

Earlier this month “Doctors Without Borders” was awarded a very well deserved first place in magazine journalism by the Association of Health Care Journalists. Congratulations, Shannon.

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