Sunday, December 13, 2009

More on Hirsch/Lanier Diatribe in Mayo Proceedings

Back in September I blogged about an article and editorial in the Mayo Clinic Proceedings: (see Sept. 1 post-- for some reason I cannot get the copy/paste function to work here to provide the link!)

That post was very long and I went into laborious detail about both the article by Laurence J. Hirsch and the accompanying editorial by William L. Lanier, with some not very complimentary comments on each--so no point now repeating all that.

I did however want to note that the Chronicle of Higher Education has now reported on the resulting controversy, which apparently has continued to simmer. If you believe the Chronicle, the focus of the fracas has been on what I identified as the one apparently valid point in a rambling and illogical attack on Pharmascolds generally--the argument that we should be as suspicious about those who take a lot of money from Pharma foes as we are about those who are in the back pocket of Pharma.

The article provides an opportunity that eluded me at the time I first posted--to get the facts straight (or at least straighter) about the actual sums made by the two Pharmascolds singled out by Hirsch, Dr. Harlan M. Krumholz of Yale and Dr. David S. Egilman of Brown. According to Hirsch, as a result of their work for plaintiffs' lawyers suing drug and other companies, the former had pocketed a total of $300,000 and the latter as much as $25M. The sums according to the Chronicle are respectively $200,000 and $2M. (Yeah, I know, those pesky decimal points--funny how they jump around all over the place when you're not looking.) On the one hand it is a further point against Hirsch's article that he was so inaccurate in naming the proper sums. On the other hand, the sums are still substantial, and I agree that anyone who makes that sort of money as a result of being paid by X (whoever X might be) is at high risk for coming to the conclusion that X is a really fine institution and that the causes undertaken by X are especially noble causes; and that those who say nasty things about X are not nice people.

So, memo to the drug industry--if you don't want the likes of Drs. Krumholz and Egilman telling the world what they think of you and your research endeavors, then in the future, be more transparent in your activities, so that we can find out about you via some route besides the legal discovery process when you are sued big time for your misdeeds. That way we would not have to depend on plaintiffs' expert witnesses, who have been paid to do the sorry job of slogging through thousands of pages of internal e-mails and memos, to tell us what you have really been up to.

Basken P. "Ex-Merck Spokesman Points Finger at Paid Consultants in Drug Lawsuits." Chronicle of Higher Education, Dec. 13, 2009 (subscription required to access on-line).


david egilman said...

Merck doesn't need a pr team they have the chronicle. Any mention of the fact that the drug killed 50-100,000? That Merck took it off the market? That the NEJM accused them of hiding data? That we disclosed our funding? That Hirsch didn't point to a single error? That we posted all the documents upon which we relied so anyone could evaluate our interpretation? (Hirsch wrote that we posted so many he didn't have time to check them.) That Merck ran a program called "neutralization" to "neutralize" (buy bully or "discredit" scientists who disagreed with its interpretation of data.

The contract arsonist and the firefighter are both paid but money does not distinguish their work..

detail detail details.

Howard Brody said...

Dr. Egilman makes a very good point here. Pharmapologists like Dr. Hirsch (apparently aided and abetted by Merck's PR juggernaut) write as if you have two equally "conflicted" groups of folks-- those on the one side who take money from the pharmaceutical industry, those on the other side who take money from plaintiff's lawyers. We should not forget that all to often, the first group displays their loyalty to their funding source by working to conceal information. The latter group, more often than not, besides being open about their own funding, makes sure that previously hidden documents are widely disseminated.

Anonymous said...

Oh please. Expert witnesses are paid by plaintiff's attorneys to provide testimony that supports the their case. Expert witnesses know this and provide the testimony that plaintiff's attorneys want and ignore other evidence.

If they don't, they are not retained. The conflict of interest is obvious and pernicious.

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