The BMJ: Evidence Based Medicine has Been Corrupted by “Corporate Interests, Failed Regulation, and the Commercialization of Academia”


Posted originally on TrialSite by Staff originally on April 21, 2022

A March 16 opinion piece in The BMJ raises some serious questions about what they call, “The illusion of evidence based medicine.” Authors Jon Jureidini and Leemon B. McHenry posit that the prominence of evidence-based medicine constituted a paradigm shift, meant to give a solid foundation in science for our medical care system. But the validity of the paradigm depends of accurate data from clinical trials, and most of these are conducted by the pharma industry and then published under the name of “senior academics.” Public release of what had been confidential pharma industry documents gives the medical world key insights into the level to which pharma-sponsored trials are mischaracterized. Getting a bit philosophical, The BMJ argues that critical rationalism is key for both the integrity of science and the role of science, “in an open, democratic society.” But this ideal is under threat by corporate power, a world in which, “financial interests trump the common good.” The dominance of massive pharma firms involves some competition, but all these players are united in working to expand the general pharma market. And while what the authors call, “free market champions” have embraced privatization, “the unintended, long-term consequences for medicine have been severe.”

Medical Schools Take Neo-Liberal Approach

Knowledge and data ownership hamper progress in science due to the fact that the pharma industry tends to suppress negative trial outcomes, not report adverse events, and not share their raw data with the research community. To quote The BMJ, “Patients die because of the adverse impact of commercial interests on the research agenda, universities, and regulators.” And duty to shareholders’ “hierarchical power structures” prioritizes both product loyalty and public relations over integrity. Further, while our fancier universities face influence from their endowments, “they have long laid claim to being guardians of truth and the moral conscience of society.” And facing reduced government funding, these schools have taken the, “neo-liberal market approach,” seeking out pharma funding, with strings attached.

Doctors as “Product Champions”

And thus, science departments at a broad swath of our universities can be seen as “instruments of industry.” When you combine firm-level control of the research agenda and the “ghosting writing of medical journal articles and continuing medical education,” scholars can transform into promotors of commercial products. Further, media reports of “industry-academe partnerships[s]” add to a general mistrust of our academic institutions that betrays the very vision of an open society. And what The BMJ calls the “corporate university” itself undermines the idea of academic leadership. Where once deans were folks with “distinguished contributions to their disciplines,” now they are more of fundraisers/academic managers who must show their “profitability” and ability to attract corporate sponsorship. And medical academia’s stars, who tend to be opinion leaders, advance their careers via industry opportunities. These folks are hired based largely on their influence on the “prescribing habits” of other doctors. The opinion leaders are also often well-paid by pharmaceutical advisory boards and speakers’ bureaus in the context of presenting results of pharma industry trials. And instead of being “independent, disinterested scientists,” they can become “product champions,” in the parlance of marketing executives.

Reforms Called For

Proposals for reform can include, “liberation of regulators from drug company funding; taxation imposed on pharmaceutical companies to allow public funding of independent trials; and, perhaps most importantly, anonymized individual patient level trial data posted, along with study protocols, on suitably accessible websites so that third parties, self-nominated or commissioned by health technology agencies, could rigorously evaluate the methodology and trial results.” For readers seeking more information, the American Medical Association’s Code of Medical Ethics Opinion 7.1.4 sets out that organization’s policies on conflicts of interest in industry-funded research.

A March 16 opinion piece in The BMJ raises some serious questions about what they call, “The illusion of evidence based medicine.” Authors Jon Jureidini and Leemon B. McHenry posit that the prominence of evidence-based medicine constituted a paradigm shift, meant to give a solid foundation in science for our medical care system. But the validity of the paradigm depends of accurate data from clinical trials, and most of these are conducted by the pharma industry and then published under the name of “senior academics.” Public release of what had been confidential pharma industry documents gives the medical world key insights into the level to which pharma-sponsored trials are mischaracterized. Getting a bit philosophical, The BMJ argues that critical rationalism is key for both the integrity of science and the role of science, “in an open, democratic society.” But this ideal is under threat by corporate power, a world in which, “financial interests trump the common good.” The dominance of massive pharma firms involves some competition, but all these players are united in working to expand the general pharma market. And while what the authors call, “free market champions” have embraced privatization, “the unintended, long-term consequences for medicine have been severe.”

Medical Schools Take Neo-Liberal Approach

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