Background Physicians' financial relationships with the pharmaceuticalindustry are controversial because such relationships may posea conflict of interest. It is unknown to what extent industrysupport of medical education and research influences the opinionsand behavior of clinicians and researchers. The recent debateover the safety of calcium-channel antagonists provided an opportunityto examine the effect of financial conflicts of interest.
Methods We searched the English-language medical literaturepublished from March 1995 through September 1996 for articlesexamining the controversy about the safety of calcium-channelantagonists. Articles were reviewed and classified as beingsupportive, neutral, or critical with respect to the use ofcalcium-channel antagonists. The authors of the articles wereasked about their financial relationships with both manufacturersof calcium-channel antagonists and manufacturers of competingproducts (i.e., beta-blockers, angiotensin-converting–enzymeinhibitors, diuretics, and nitrates). We examined the authors'published positions on the safety of calcium-channel antagonistsaccording to their financial relationships with pharmaceuticalcompanies.
Results Authors who supported the use of calcium-channel antagonistswere significantly more likely than neutral or critical authorsto have financial relationships with manufacturers of calcium-channelantagonists (96 percent, vs. 60 percent and 37 percent, respectively;P<0.001). Supportive authors were also more likely than neutralor critical authors to have financial relationships with anypharmaceutical manufacturer, irrespective of the product (100percent, vs. 67 percent and 43 percent, respectively; P <0.001).
Conclusions Our results demonstrate a strong association betweenauthors' published positions on the safety of calcium-channelantagonists and their financial relationships with pharmaceuticalmanufacturers. The medical profession needs to develop a moreeffective policy on conflict of interest. We support completedisclosure of relationships with pharmaceutical manufacturersfor clinicians and researchers who write articles examiningpharmaceutical products.
Source Information
From the Departments of Medicine (H.T.S., G.C., A.S.D.), Health Administration (K.O., A.S.D.), and Public Health Sciences (K.O.), University of Toronto; the Department of Medicine, Mount Sinai Hospital (A.S.D.); and the Department of Medicine, Toronto Hospital (A.S.D.) — all in Toronto.
Address reprint requests to Dr. Detsky at Mount Sinai Hospital, Rm. 427, 600 University Ave., Toronto, ON M5G 1X5, Canada.
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