Financial disclosure rules for researchers are awesome, and not enough.
Since I started representing people injured by medical devices, one of the most useful tools I’ve found is the Open Payments website. Open Payments is a feature of Obamacare added by a Republican, Chuck Grassley. It requires drug and device companies to report their financial transactions and gifts to doctors and hospitals.
It’s pretty surprising stuff. Surgeons — who consider themselves completely independent — routinely have received multiple $200+ meals from companies that make the devices they use. Why would the companies spend that money unless they thought it was getting something? Knowing the amounts paid at least gives the patient a chance to research cheaper or more effective alternative treatments.
A new article from The Chronicle of Higher Education looks at a different type of disclosure rule: the rules set by universities regarding disclosures by researchers of industry payments. The point of the article is that disclosure is not enoughbecause the doctors with the conflicts are *still* given the opportunity to publish their opinions. Those opinions, unquestionably biased, thus still influence other doctors’ treatment decisions. The article shows the example of a set of treatment guidelines related to treating depression with drugs published in the journal CNS Spectrums. The article is written almost exclusively by authors with money ties to the companies that make the drugs that are recommended in the guidelines. Many of the drugs recommended have never been shown to perform better or safer than cheaper alternatives.
The article then focuses different ways doctors have been able to game the system to avoid the universities’ financial disclosure requirements. It is extremely well written and highly recommended. As always, the reminder to patients is to always ask questions of the doctor when treatment is recommended. Are there any other treatments I could consider? Have you ever received money from any of these companies? Is this an on-label or off-label use? What are the side effects? What could go wrong? Have you ever done this before?