3_Pharma as Political Player - Abraham

3_Pharma as Political Player - Abraham - MEDICINES,...

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For personal use. Only reproduce with permission from The Lancet Publishing Group. MEDICINES, SOCIETY, AND INDUSTRY II 1500 THE LANCET • 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. 33 Quantitative data about the industrial interests of expert scientific advisers to the British drug regulatory authorities remained confidential to ministers until the late 1980s. 34 When made public, these data showed that, in 1989, only a fifth of the expert advisers on the CSM or the Medicines Commission had neither personal nor non-personal financial interests in the industry. 35,36 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). 37 Since 1989, the system for declaration of interest by CSM members has been completely transparent. Furthermore, when assessing new drug applications, 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”. 38,39
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