A leading medical journal is launching a global campaign to separate medicine from big pharma, linking industry influence to the pelvic mesh scandal that injured hundreds of women.
The BMJ says doctors are being unduly influenced by industry-sponsored education events and industry-funded trials for major drugs.
Those trials cannot be trusted, the journal’s editor and a team of global healthcare leaders write in a scathing editorial published on Wednesday.
The “endemic financial entanglement with industry is distorting the production and use of healthcare evidence, causing harm to individuals and waste for health systems”, they write.
They are calling for governments to start funding independent trials of new drugs and medical devices, rather than relying on industry-funded studies. Sponsored research is more likely to find a favourable result compared to independent research, studies show.
And they want medical associations to discourage doctors from going to industry-funded education events.
But doctors have hit back, questioning who will pay for education and medical research if the pharmaceutical industry is excluded.
Assistant Professor Ray Moynihan, a Bond University researcher studying the link between money and medicine, and is one of the leaders of The BMJ’s campaign.
“When we want to decide on a medicine or a surgery, a lot of the evidence we used to inform that decision is biased,” he says.
“It cannot be trusted. Because so much of that has been produced and funded by the manufacturers of those healthcare products.”
Dr Moynihan points to the example of medical giant Johnson & Johnson, which sold pelvic mesh to thousands of Australian women. It knew the mesh could cause serious harm, but never properly warned women of the risks
Victims of Ethicon’s faulty pelvic mesh have spoken outside court following a successful class action lawsuit.
In the US, a court found the same company deliberately played down the dangers and oversold the benefits of opioids, stoking the addiction crisis that claims the lives of 130 Americans a day. The company plans to appeal in both cases.
The BMJ also wants policies in place to stop doctors receiving professional development points for attending industry-sponsored education events.
Between 2011 and 2015, pharma companies spent more than $286 million on events for Australian doctors, nurses, pharmacists and specialists, according to University of Sydney research.
Many received free food and beverages, and some got free flights and accommodation for an overseas conference.
Studies show doctors who attend industry-sponsored events are more likely to prescribe the company’s drugs.
But the Australian Medical Association questions how medical education and research would be funded without the involvement of the pharmaceutical industry.
“Who is going to fund all this? Is the government going to fund it?” says Dr Chris Moy, chair of the association’s ethics and medico-legal committee.
“Money makes the world go round, in simple terms. Research will not happen unless there is funding.
“Medicine is always going to need pharma companies. We cannot be too brutal on them.”
The Royal Australasian College of Surgeons says it requires its members not to accept money or gifts in exchange for using certain devices or surgeries, and they must declare any conflicts of interest – for example if they are on a company’s payroll – to their patients.
Medicines Australia, which represents major pharmaceutical companies, did not return a request for comment by deadline.
The Medical Technology Association of Australia says its members are bound by a “code of practice which aims to ensure that healthcare providers are not influenced in their decision-making through financial or other inducements to choose one device over another”.