IN DRUG STUDIES, MONEY COUNTS

Funding: Drug Company Sponsorship Makes For Less Critical Views,
Researchers Say.

(Chicago)- Studies on the cost-effectiveness of drugs are far more
likely to report favorable findings if they are sponsored by the drug
companies themselves rather than independent groups, researcher5s found.

Their study - funded by a pharmaceutical company - appears to confirm
long-held suspicions that doctors are less critical about a drug's
safety and effectiveness when they have financial ties to the
manufacturer.

"It is possible that these factors may result in some unconscious
bias" in interpreting a study's findings, the researchers said.

Last year, the conflict-of-interest issue made headlines when a report
found that the vast majority of doctors who defended the safety of
calcium channel-blockers had a financial relationship with
manufacturers of the blood-pressure pills.

In the current study, published in today's Journal of the American
Medical Association, the researchers looked at 44 studies on the
cost-effectiveness of cancer drugs. Twenty of the studies were funded
by pharmaceutical companies and 24 by nonprofit organizations.

Those sponsored by nonprofit groups reached unfavorable conclusions 38
percent of the time, compared with just 5 percent for studies
sponsored by pharmaceutical companies. Also, researchers in
company-backed studies were slightly more likely to over-state the
cost-effectiveness.

Some researchers receive funding directly from pharmaceutical
companies. Some get funding in the form of honoraria or travel
expenses. Some hold stock in drug companies and profit directly from
increased drug sales.

Dr. Charles Bennett, the lead author and a professor at Northwestern
Medical School, said that in addition to the possibility of
unconscious bias, there could be other explanations for the findings.

For example, pharmaceutical companies are given early looks at
studies. That enables them to abandon studies that appear to be
unfavorable and focus on those they think are going to be positive,
Bennett said.

Bennett said the findings should not be seen as a major criticism of
pharmaceutical companies.

"Our study was sponsored by a pharmaceutical company," he said, adding
that the company, Amgen Inc., did not comment on it before
publication. He also said his paper analyzed studies sponsored by
Amgen, which fared no better than other company-sponsored studies.

Bennett said the best thing would be to stop pharmaceutical
companies from sponsoring research, but to get other types of sponsors
to underwrite studies, too, such as managed-care organizations.

Amgen spokesman David Kaye said: "If you want the best physicians in
the world, you have to let them run the trials. If you kill a study or
over-control it, word gets out and the best investigators won't do you
studies."

Others not involved with the study said the findings raise serious
concerns.

"The best hypothesis I can tell for that is the person doing the
research has internalized the values of their funder," said Sheldon
Krimsky, a Tufts University professor who studies scientific integrity
and conflict of interest and who wrote an editorial about the study in
JAMA.

Dr. Sidney Wolfe, director of Public Citizen's Health Research Group
in Washington, agreed: "As in other studies of the drug industry, this
shows the financial interests of the drug industry rides over the
actual data."