Guidelines: Guides to Profit?

By John Fauber, Milwaukee Journal Sentinel/Medpage Today and Ellen Gabler, Milwaukee Journal SentinelPublished: December 19, 2012.

The stated intent of treatment guidelines is to “guide” clinicians’ treatment of patients with a series of recommendations based on evidence. But that intent may not be universally reflected in published guidelines and the disconnect is all about money. Money Talks Doctors with financial ties to drug companies have heavily influenced treatment guidelines ,an analysis by the Milwaukee Journal Sentinel and MedPage Today has found. Critics say those financial relationships have corrupted the guideline process so that the end products , make dangerous or ineffective recommendations. Industry and some doctors counter that those with conflicts are often top experts in their field. The Journal Sentinel/MedPage Today examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the U.S. These drugs sit in the medicine cabinets of millions of Americans — Nexium (esomeprazole magnesium) for acid reflux, Lipitor (atorvastatin) for high cholesterol, Cymbalta (duloxetine) for depression, and OxyContin (oxycodone) for pain. Their collective sales topped $94 billion in 2011, accounting for 30% of drug revenue in the U.S. An analysis of the guideline panels, which involved 293 doctors, found: Nine guidelines were written by panels where more than 80% of doctors had financial ties to drug companies. Four panels did not require members to disclose any conflicts of interest.Of the 16 guideline committees that required disclosure, two-thirds of the panel members had ties to drug companies.Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing, specifically guidelines for anemia, chronic pain, and asthma. More…..

Carl Tuttle