MEDICAL JOURNAL'S CONFLICTS ALLEGED

Articles' Authors Had Drug-Company Ties

The New England Journal of Medicine -- the world's top-ranked medical
journal and a leading voice in biomedical ethics -- apparently has
violated its own ethics policy numerous times in the last three years,
publishing articles by researchers with drug company ties and not
disclosing the potential conflicts of interest.

In an analysis of 36 ``drug therapy'' review articles since 1997, the
Los Angeles Times has identified eight articles by researchers with
undisclosed financial links to drug companies that marketed treatments
evaluated in the articles.

The journal's interim editor-in-chief, Dr. Marcia Angell, said
Wednesday that the journal's practices were at odds with its
guidelines on financial conflicts of interest.

``We're going to try to do the right thing and bring our practice into
conformity with our policy. . . . There was a problem with the (drug
therapy) series. There was a misinterpretation of exactly what our
policy was,'' Angell said.

Among the articles questioned in the drug therapy series was a 1997
review of multiple sclerosis treatments. The lead author, Dr. Richard
A. Rudick of the Cleveland Clinic Foundation, received research funds,
speaking fees and travel expenses from three drug companies whose
treatments were discussed in the article, he said in an interview.

In another instance, the sole author of a 1998 review of breast cancer
treatments, Dr. Gabriel N. Hortobagyi of the University of Texas M.D.
Anderson Cancer Center, said he had received consulting fees, research
funds and speaking fees from multiple companies that make drugs
assessed in his article.

Publication of those articles and several others goes against the
journal's restrictive conflict-of-interest policy: It ``prohibits
editorialists and authors of review articles from having any financial
connection with a company that benefits from a drug or device
discussed in the editorial or review article.''

The Times' analysis was conducted after reporting last month that the
journal ran a review of hair-loss treatments by a researcher with
undisclosed financial ties to the companies that market the popular
drugs Rogaine and Propecia. Dr. Vera H. Price, a dermatology professor
at the University of California-San Francisco, had served as a
consultant to Pharmacia & Upjohn and Merck & Co. just before writing
the review, and her research has been funded by the companies.