Are Drug Industry-Psychiatry Ties Huge?
Watchdog and anti-psychiatry organizations have long been saying that researchers and practitioners are hand-in-glove with "Big Pharma," and it appears that at least in some cases this is true. Limited data shows that drug companies tend to pay psychiatrists more than they do other doctors, and that those who receive money may tend to write more prescriptions for medications made by the companies who paid them. Expect this investigation to continue for a long time.
“With every new revelation, our credibility with patients has been damaged, and we have to protect that first and foremost,” Steven Sharfstein, a former president of the APA and now president of the Sheppard Pratt Health System in Baltimore, told the New York Times. “I think we need to review all arrangements between doctors and industry and be very clear about what constitutes a conflict of interest and what does not.”
Pending in the US Senate is the Physician Payments Sunshine Act that would require drug and device manufacturers to publicly disclose anything of value given to physicians, such as payments, gifts, honoraria or travel above certain amounts. The currently amended bill has the support of major drug manufacturers and pharma associations. It certainly seems like a big step in the right direction.
Does all this worry you? If you are taking prescribed psychiatric medications, does this make you wonder whether your doctor chose your meds because of drug company incentives? For me personally, it doesn't - my psychiatrist has always shown that his primary concern is to find the right meds that work for me. But I know people who say their pdocs won't change their meds no matter what, and that, combined with this probe, does make me wonder about those doctors. What's your opinion? Leave a comment.
~Marcia
Comments
This issue goes way beyond whether or not your psychiatrist will prescribe one med over another.
This issue strikes at the core of the corruption in psychiatric drug research. The doctors so far under scrutiny are prominent academic psychiatrists whose research has basically been subsidized by drug companies. They are considered Key Opinion Leaders in their field, and thus what they say carries a lot of weight.
So far three — Dr. Melissa Del Bello, Dr. Joseph Biederman and Dr. Alan Schatzberg (the president-elect of the American Psychiatric Association) have been named. Up to 30 more are reportedly yet to be revealed.
Given the massive clout of these professors, the ripple effects of their drug ties pervade much of the industry.
So no, this is not a matter of a few “bad apples.” This is corruption of psychiatric research at the highest levels, and should be taken very seriously. Read the blog of psychiatrist Dr. Daniel Carlat (The Carlat Report) if you have any doubts.
Back in the early 90s I was sitting at lunch with a co-worker. We were both computer geeks and he was looking at the computer ads in the L.A. Times. He remarked that the hospital his wife worked at could save a lot of money buying computers from these dealers advertising in the Times. He said the hospital was paying three times the advertised prices for their PCs. He was going to have his wife suggest that the hospital look into this.
A week or so later I asked him whether the hospital was going to follow his suggestion. This is what he had found out… The hospital his wife worked at was non-profit. This hospital and around 10 other non-profit hospitals were all owned by the same corporation. The corporation was *not* non-profit. These hospitals were required to purchase all their equipment and supplies from the parent corporation.
How to use non-profit institutions to scam the public in one easy lesson.
My doctor is not a psychiatrist; however he has always been very reasonable about switching medications when one didn’t work or had severe side effects. I’d really shy away from one who didn’t.
It will be very interesting to find out how many doctors whose research was subsidized by pharmaceutical firms ended up “finding” only good things to say about the drugs developed by said firms.
I work at a government hospital and the rules on what drug companies can do for us have gone over-the-top restrictive. They can’t even provide sandwiches for seminars anymore. It has to be a “non-meal snack.” So, we ask for pizza cut into 20 pieces for each pie. It gets pretty silly, but yes, there are rules to help prevent influence.
There should a probe into it. I guess not every psychiatrist is involved. But even if someone is doing so, that must be found out.
This isn’t just an issue in the US. I’m currently reading Infidel, biography by Ayaan Hirshi Ali. She wrote about working briefly for Glaxo (AIDS and malaria research company) as a salesperson in Holland in 2000. She left because she didn’t like being a part of the manipulative sales pitches she was expected to use to make sales of Imigran (migraine medication).
I believe the Big Pharma/psychiatry connection is another example of anti-psychiatry in action. For anti-psychiatry groups, it is a matter of repackaging profits from one sector of a medical economy to another. For example, some psychologists might argue that psychotherapy could replace medications for even more complicated medical conditions such as bipolar or schizophrenia. But, should we assume that these services could be provided by these psychologists free of charge? Couldn’t we assume that psychotherapy would be needed throughout a bipolar sufferer’s life? And, doesn’t this also illustrate an economic incentive to ask a patient to continously attend psychotherapy sessions at cost? It’s still the same song and dance. I can just as easily turn the table on psychotherapy and argue that psychologists are “in on it” and want to take your money by providing scientifically-invalidated psychotherapeutic methods. But, the reality is that both fields (psychology and psychiatry) have much to offer. So, attacking pharmaceutical companies is not the answer.
Let me explain…
Isn’t the pharmaceutical industry tied to other areas of medicine as well–cardiology, neurology, surgery, etc.? So, with this rationale, since pharmaceutical industries promote heart medication, then patients should stop taking heart medication and find alternative, naturalistic ways to reduce their heart disease. This is ludicrous! By doing so would undermine heart problems for patients and compromise their health.
Another example involves a blog that I read that commented on a book by Robert Whitaker who addressed the horrible treatments against the mentally ill as if to discredit the entire field of psychiatry. Yes, there have been many awful techniques used to try to “treat” mental illness. But, by this rationale, we might easily conclude that the entire field of medicine should be discredited as well–considering the barbaric treatments developed to cure people in the past. An interesting example is how people were “bled” to help remove sickness from the body–a practice that would be considered mad by today’s standards. So then, should we discredit medicine altogether? I don’t think so.
Psychiatry is still in the infancy stages of development. It is the youngest of the medical fields and much is to be learned by scientists. Much of this research is paid for by profit driven companies. This may seem suspicious, but, who exactly is willing to pay for this research? The taxpayer? LOL! Yeah, ok! And, while there exist economic incentives for psychiatrists, so are there economic incentives for your neurosurgeon as well. Why not badger them too? It’s because mental illness cannot be seen, touched, tasted, but instead can be most oftentimes felt or experienced. This subjective and abstract approach is difficult for those people who do not have a mental illness to understand. And now, we are learning more about how the brain works through this same research that people are criticizing. And yet, this is the real science–the empirical, observable evidence that is necessary for improving the lives of those who suffer with mental illness.
So, in my opinion, to draw a conclusion that there exists a vast conspiracy involving pharmaceutical companies and psychiatrists is simply an attempt to undermine the seriousness of mental illness. But, one must keep in mind that conspiracy theories are sexy, they keep people gossiping, and they generate news and media buzz.
It is quite possible that when we look back on these days hundreds of years from now, our future society will be shocked by the disturbingly, high level of pseudoscience that permeated throughout our culture in the form of anti-psychiatry.
But, in the meantime, the anti-psychiatry groups would prefer that you use your money for more naturalistic, altnernative, holistic, “safe” treatments. I wonder if these treatments will be free of charge?