Sir,
There are two more subtle but probably more important ways in which Big
Pharma influences medicine than the ways you describe: first, it can, over
years, alter the critical mass of medical academia and secondly influence
what we learn about disease.
In my own specialty of Respiratory Medicine we have over fifty clinical
academic depatments researching airways obstruction but none researching
tuberculosis (TB). The last such department was killed off in 1989 when
the then incumbent retired.
In order to be considered for a chair an impressive list of publications
will be required. If the applicant has an interest in a pharmaceutically
rewarding disease, he/she will have been able to obtain research monies
relatively easily and built up the necessary CV. With no pharmaceutical
input the CV is llikely to be comparatively thin. Thus over a couple of
decades the critical academic mass of a major specialty has become
unbalanced with a huge bias towards the dieases of the rich who can afford
the newly developed drugs at the expense of the poor who cannot.1
Secondly the immnense funding by Big Pharma for post graduate education
has distorted our knowledge. 2 Two of the TB outbreaks of 2001 were caused
by the index cases being misdiagnosed as asthma. Every General
Practitioner and Respiratory Consultant in the country will have been
asked to attend many Post Graduate meetings sponsored by drug companies
producing asthma drugs where they will have been told that cough is a
symptom of asthma. None will have ever been to a TB drug sponsored meeting
where they would be told that cough is a symptom of TB.
I fear that if drug companies pull out of funding most of clinical medical
academia and post graduate education would collapse. But in the long run
that may be better for patients.
Refs.
1. Davies PDO. The Challenge of tuberculosis. J Roy Soc Med 2003;96:262-
265.
2.Davies P. Industry funding in medical education [letter]. Lancet
2002;359:1949-50.
3. Leese J. tuberculosis - a 19th century disease in the 21st century.
CMO's Update, 31 october 2001, p.4.
Competing interests:
None declared
Competing interests:
No competing interests
05 June 2003
Peter D O Davies
Consultant Physician
Cardiothoracic Centre, Thomas drive, Liverpool, L14 3PE
Rapid Response:
No more free lunches
Sir,
There are two more subtle but probably more important ways in which Big
Pharma influences medicine than the ways you describe: first, it can, over
years, alter the critical mass of medical academia and secondly influence
what we learn about disease.
In my own specialty of Respiratory Medicine we have over fifty clinical
academic depatments researching airways obstruction but none researching
tuberculosis (TB). The last such department was killed off in 1989 when
the then incumbent retired.
In order to be considered for a chair an impressive list of publications
will be required. If the applicant has an interest in a pharmaceutically
rewarding disease, he/she will have been able to obtain research monies
relatively easily and built up the necessary CV. With no pharmaceutical
input the CV is llikely to be comparatively thin. Thus over a couple of
decades the critical academic mass of a major specialty has become
unbalanced with a huge bias towards the dieases of the rich who can afford
the newly developed drugs at the expense of the poor who cannot.1
Secondly the immnense funding by Big Pharma for post graduate education
has distorted our knowledge. 2 Two of the TB outbreaks of 2001 were caused
by the index cases being misdiagnosed as asthma. Every General
Practitioner and Respiratory Consultant in the country will have been
asked to attend many Post Graduate meetings sponsored by drug companies
producing asthma drugs where they will have been told that cough is a
symptom of asthma. None will have ever been to a TB drug sponsored meeting
where they would be told that cough is a symptom of TB.
I fear that if drug companies pull out of funding most of clinical medical
academia and post graduate education would collapse. But in the long run
that may be better for patients.
Refs.
1. Davies PDO. The Challenge of tuberculosis. J Roy Soc Med 2003;96:262-
265.
2.Davies P. Industry funding in medical education [letter]. Lancet
2002;359:1949-50.
3. Leese J. tuberculosis - a 19th century disease in the 21st century.
CMO's Update, 31 october 2001, p.4.
Competing interests:
None declared
Competing interests: No competing interests