In November, I praised "a chilling story" by Peter Whoriskey in The Washington Post [that] shows how drug companies have misused their influence and their expertise to corrupt and distort research on new drugs." It was an important piece.
Now he is back with another pharmaceutical industry story, which leads with whether antidepressants should be prescribed to people suffering from grief such as that produced by the loss of a spouse. This time, I think Whoriskey has missed something important.
Both stories are part of a Post special report entitled "Can Medical Research Be Trusted?" These are important stories, and we need this kind of tough reporting on the powerful pharmaceutical industry. The stories detail suspicious practices by the pharmaceutical industry that have led to increased profits–sometimes at the expense of patients or of taxpayers who are paying the bills.
The story on antidepressants and grief turns on a new recommendation by the American Psychiatric Association that drops the prior restraint against treating bereavement with medication. Whoriskey reports that "eight of 11 members of the APA committee that spearheaded the change reported financial connections to pharmaceutical companies — either receiving speaking fees, consultant pay, research grants or holding stock, according to the disclosures filed with the association."
That is certainly reason to be suspicious about the new recommendation, which will likely spur sales of antidepressants. But Whoriskey seems to overlook what one source tells him, "that if no financial ties were permitted, many knowledgeable psychiatrists would be excluded because so many university studies are funded by pharmaceutical companies."
The reason for the ties between so many top-tier psychiatric researchers and the pharmaceutical industry is that there are few other sources of funding. Foundations and the government have not provided enough support for research on depression, schizophrenia, bipolar disorder, and other serious mental illnesses. There is no "schizophrenia awareness month" to correspond to breast cancer awareness month. Ball players who swing pink bats to support breast cancer research don't swing bats in schizophrenia colors; there are no schizophrenia colors.
Whoriskey is correct to point out the potentially compromising financial ties between industry and the researchers who made the recommendation on bereavement. But he would find the same ties in any group of psychiatric researchers, whether they're studying depression, schizophrenia, bipolar disorder, or anything else. Further down in the story, he acknowledges this, when a psychiatric association official tells him:
“Our dilemma is: Do we not have the world’s experts, or do we have limits and disclosures [of their financial ties],” Scully said. “We decided to have some balance here. You could say absolutism should prevail, but then where are you going to get your experts?”
Whoriskey's response is that "it’s hardly impossible to find medical experts without financial ties to industry…A survey of academic researchers, for example, showed that 36 percent of full professors at medical schools report no financial connections to the industry in the previous year."
Let's turn that around and say it again: Almost two-thirds of full professors at medical schools do have financial ties to industry. And they are probably the top people on the faculty; the pharmaceutical industry doesn't hire the laggards.
Whoriskey does a good job of disclosing the industry ties, which we should all agree are a bad idea. He doesn't do as well with the other part of the story: documenting the shortfall of research funding from non-industry sources, especially in psychiatry. That is why so many experts fall into the arms of industry.
-Paul Raeburn
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