The long arm of the pharmaceutical industry continues to pervade practically every area of medicine, reaching those who write guidelines that shape doctors’ practices, patient advocacy organizations, letter writers to the Centers for Disease Control and Prevention and even oncologists on Twitter, according to a series of papers on money and influence published in JAMA Internal Medicine and an article on NPR.
Researchers Ray Moynihan and Lisa Bero wrote in an accompanying commentary that the “very way we all think about disease – and the best ways to research, define, prevent, and treat it – is being subtly distorted because so many of the ostensibly independent players, including patient advocacy groups, are largely singing tunes acceptable to companies seeking to maximize markets for drugs and devices.”
More than two-thirds of patient advocacy organizations that responded to a survey indicated that they had received industry funding in their last fiscal year. For most, the money represented a small share of their budget. But 12 percent said they received more than half of their money from industry.
US Centers for Disease Control and Prevention ( CDC) recently developed guidelines for prescribing opioids for chronic pain. When the draft guidelines were released , there was criticism. Some organizations argued that the development of the guidelines was not transparent and the recommendations were based on weak evidence. Subsequently, the CDC postponed the release of the guidelines and opened them to public comment for a 30-day period.
Researchers Moynihan and Bero analyzed these comments to identify levels of support for the guidelines and whether financial relationships with opioid manufacturers were associated with opposition to the guidelines. The final guidelines were released in March 2016.”
158 organizations formally submitted comments after the proposed guidelines were released in February 2016, and 80 percent of them were supportive, though some had recommendations for changes. Organizations that received funding from opioid manufacturers were less supportive of guidelines proposed by the CDC to limit prescribing of the drugs for chronic pain.
Of the 158 organizations, 45 (28.5%) received funding from opioid manufacturers, 25 (15 .8%) had funding ties to other companies in the life sciences, 64 (40.5%) received no funding from the life sciences industry, and funding of the remaining 24 (15.2%) was not known. Of the organizations that received funding from opioid manufacturers, none disclosed these funding sources in their comments; of the organizations that received funding from the life sciences industry, 6 (24%) disclosed their funding.
Fifty-two organizations (32.9%) were supportive of the guidelines without additional recommendations, 75 (47. 5%) were generally supportive with recommendations, 18 (11.4%) were generally not supportive with recommendations, and 13 ( 8.2%) were not supportive.
Opposition to the guidelines was more frequent among organizations with funding from opioid manufacturers than those without funding from the life sciences industry, both overall and for recommendations about limits on opioid dosing and the length of opioid treatment.
Among the 45 groups that received money from opioid makers, though, the level of support was only 62 percent. And none of those groups disclosed their funding sources in their comments. (The CDC did not ask or require them to do so.)
“More people are dying than ever before from these products, and it’s important to know how the market is shaped by the spending of drug companies,” G. Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at Johns Hopkins 1University, said in an interview.