For personal use. Only reproduce with permission from The Lancet Publishing Group.
MEDICINES, SOCIETY, AND INDUSTRY II
• Vol 360 • November 9, 2002 • www.thelancet.com
over 30 years ago the British government recognised that
such conflicts of interest were inappropriate. Nevertheless,
the ABPI refused to lend support to the policy proposal and
it was never implemented.
Quantitative data about the industrial interests of expert
scientific advisers to the British drug regulatory authorities
remained confidential to ministers until the late 1980s.
When made public, these data showed that, in 1989, only a
fifth of the expert advisers on the CSM or the Medicines
financial interests in the industry.
In 1996, this figure
remained as low as a quarter. Of the 23 members of the
CSM with financial interests in 1996, three had interests in
at least 20 companies, seven had interests in at least ten and
20 had interests in at least five (table 2).
Since 1989, the system for declaration of interest by
members of the CSM who have conflicts of interest with the
particular product under discussion are asked to leave the
room. However, this procedure does not address the general
effects of conflicts of interest on experts’ perspectives
towards the industry. Experts who gain a reputation for
being critical of some industry products, irrespective of the
particular drug in question, may find, or at least perceive,
that their interests in the industry are threatened. As a
former member of the CSM put it, the expert “would lose
his [or her] personal consultancy, his department would
lose their large grants, and the rest of the pharmaceutical
industry would blackball him”.