Medical journals try objectivity

[Guest guest]

http://www.tribune-chronicle.com/edit/story/thursday.asp

September 13, 2001

Medical journals try objectivity

Tribune Chronicle Editorial

For all the fuss about prescription drug costs and the often Draconian

''solutions'' to the problem suggested by pols, the root of the problem

comes down to physicians' individual decisions to prescribe certain drugs -

often based on their most recent visit with a drug salesman. And with easy

access to medical journals over the Web, doctors increasingly enter exam

rooms to find a patient waiting with a study in hand, asking for a

particular drug, at which point even the most conscientious physicians cry

''uncle'' rather than spend precious minutes arguing about a prescription.

Those patients of course assume that those prestigious medical journal

articles are totally objective. This week the editors of the world's leading

medical journals essentially admitted they are not when they adopted a new,

uniform policy concerning drug studies. Henceforth, a dozen leading journals

say in a joint editorial, they will require study authors to affirm that

study sponsors - whether drug manufacturers or others - gave the authors

unfettered access to all data and freedom to report all findings.

Thus the journals unveiled a little secret of drug studies: The researchers

often use intermediaries to collect raw data, and those intermediaries often

are the drug companies with a vested interest in making their product look

good. Despite physicians' institutional grousing about study biases, one

need not look very long to find a physician who rather enjoys being on the

gravy train of clinical trials, conferences and speaking engagements, even

as he denounces drug companies' marketing practices.

Now there's nothing wrong with drug companies using every ethical means

available in a free market to put the best spin possible on their products.

Every business does exactly the same thing. It's called marketing.

The significance of the medical journals' move is that by demanding, for the

first time, true objectivity in the studies they publish concerning

prescription drugs, the journals are removing a significant excuse for

prescribing newer, higher-cost brand-name drugs, when older, sometimes

generic drugs will get the job done at much lower cost. In short, physicians

now will be forced to face up to their shared responsibility for the cost of

prescriptions. That's a thoroughly market-oriented development for the good.