Views & Reviews Review of the Week

Becoming Ben

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1856 (Published 01 October 2008) Cite this as: BMJ 2008;337:a1856

Financial conflicts - shock horror

Andrew Wakefield is continuously attacked on the basis that he had
crippling financial conflicts of interest - with regard to his research in
MMR - which he did not disclose.

At the time, the Lancet did not request authors to disclose conflicts
of interest. So Dr Wakefield broke no rules. Perhaps more pertinent is the
fact that a huge number of researchers, and those who write clinical
guidelines, are far more 'conflicted' than Andrew Wakefield ever was - or
is - or probably could ever be.

When the National Cholesterol Educational Program (NCEP) produced
thier last set of guidelines, no financial conflicts were initially
identified. (The panel recommended far more intensive cholesterol lowering
than previous guidelines, and would therefore encourage far greater
prescribing of statins).

After several petitions to the National Insitutes of Health (The
parent organisation to NCEP), the conflict statement was - reluctantly -
published. (See below). There were ten members of the panel. (These
conflicts were publishes on the NIH website, and are in the public domain
(Ref 1))

Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer,
Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca;
he has received research grants from Merck, Abbott, and Glaxo Smith Kline.

Dr. Cleeman has no financial relationships to disclose.

Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck,
and Kos; she has served as a consultant for Pfizer, Bayer, and EHC
(Merck); she has received unrestricted institutional grants for Continuing
Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth,
AstraZeneca, and Bristol-Myers Squibb Medical Imaging; she has received a
research grant from Merck; she has stock in Boston Scientific, IVAX, Eli
Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical,
and Biosite.

Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid
Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Esperion, and
Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid
Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and
Novartis.

Dr. Clark has received honoraria for educational presentations from
Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has
received grant/research support from Abbott, AstraZeneca, Bristol-Myers
Squibb, Merck, and Pfizer.

Dr. Hunninghake has received honoraria for consulting and speakers
bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for
consulting from Kos; he has received research grants from AstraZeneca,
Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and
Pfizer.

Dr. Pasternak has served as a speaker for Pfizer, Merck,
Merck/Schering-Plough, Takeda, Kos, BMS-Sanofi, and Novartis; he has
served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer
Health Solutions, Johnson & Johnson-Merck, and AstraZeneca.

Dr. Smith has received institutional research support from Merck; he
has stock in Medtronic and Johnson & Johnson.

Dr. Stone has received honoraria for educational lectures from
Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-
Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a
consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant.

To castigate one doctor for his fatal conflicts of interest when
writing a clinical paper seems to be humbug of the highest possible level
when we allow other doctors to write treatment guidelines whilst having
such major financial conflict of interest. Sauce for the Goose must also
be sauce for the gander.

Ref 1:
http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3upd04_disclose.htm

Competing interests:
None declared

Competing interests: No competing interests

20 October 2008
Malcolm Kendrick
Salaried General Practitioner
Brownley Green Medical Centre M22 4GL