Big Pharma's Enclosure of Academic Medicine

[marmar]

from OnTheCommons.org:



Big Pharma's Enclosure of Academic Medicine
Marcia Angell documents how drug companies have corrupted the integrity of drug research, medical education and clinical practice.

By David Bollier


Anyone who works in clinical medical practice is keenly aware of Big Pharma’s relentless and intrusive marketing practices. You can’t avoid it. The pens, notepads and schwag plastered with the brand-name anti-depressants. The ubiquitous “detail” salespeople who schmooze up doctors and shower them with free samples. The physician junkets to exotic resorts to hear “educational” lectures by esteemed leaders of the field.

I know all this. What I didn’t realize was how thoroughly drug marketers have corrupted academic medicine — the research at medical centers, the education of new doctors at medical schools, and daily clinical practice. In the May-June issue of the Boston Review, Marcia Angell, the former Editor of the New England Journal of Medicine, documents in devastating detail how the drug industry has insinuated itself into every imaginable nook and cranny of academic medicine in order to sell its drugs.

The best indication of its success is the invisibility of the marketing. The sales propaganda has gotten so effective that it is brilliantly disguised as high-minded “education.” Marketing has become a normative part of medical education, research and practice.

In her sober, understated indictment, Angell, Senior Lecturer in Social Medicine at Harvard Medical School and author of The Truth About the Drug Companies, writes:

The boundaries between academic medicine — medical schools, teaching hospitals, and their faculty — and the pharmaceutical industry have been dissolving since the 1980s, and the important differences between their missions are becoming blurred. Medical research, education, and clinical practice have suffered as a result.

Academic medical centers are charged with educating the next generation of doctors, conducting scientifically important research, and taking care of the sickest and neediest patients. That’s what justifies their tax-exempt status. In contrast, drug companies — like other investor-owned businesses — are charged with increasing the value of their shareholders’ stock. That is their fiduciary responsibility, and they would be remiss if they didn’t uphold it. All their other activities are means to that end. The companies are supposed to develop profitable drugs, not necessarily important or innovative ones, and paradoxically enough, the most profitable drugs are the least innovative. Nor do drug companies aim to educate doctors, except as a means to the primary end of selling drugs. Drug companies don’t have education budgets; they have marketing budgets from which their ostensibly educational activities are funded.

This profound difference in missions is often deliberately obscured — by drug companies because it’s good public relations to portray themselves as research and educational institutions, and by academics because it means they don’t have to face up to what’s really going on.

Angell’s essay marshals a considerable amount of empirical research to make her case. And while not all of the charges are new or shocking, the steady accretion of facts makes a powerful case that academic medicine has willingly surrendered its integrity and independence to the drug industry — with troubling consequences for the safety and scientific merit of many drugs and types of medical treatment. ............(more)

The complete piece is at: http://onthecommons.org/content.php?id=2739