Saturday, July 5, 2008

If They Tell the Truth, Shut Them Down: Drug Industry Attacks the UBC Therapeutics Initiative

Both in writing HOOKED and in other work that I do related to evidence-based medicine, I periodically rely on the reports of the Therapeutics Initiative at the University of British Columbia. As there are relatively few bodies around the world that have adequate staff and budget to really comb through the published data on pharmaceuticals and look behind the industry spin for the scientific truth, groups that perform this role are especially precious to those of us who care about doing what's best for the patient. (Just to give one example, the group at the Therapeutics Initiative was among the first to lay out carefully the case against the COX-2 drugs like Vioxx, several years before the rest of the medical world caught on to their risks and nearly-absent benefits.)

You will now not be too surprised to learn that the reaction of the drug industry to the existence of such an operation is--shut it down.

As Anne Silversides reports in the Canadian medical association journal CMAJ( the Initiative is supported by a $1M grant from the province of BC. The provincial government was apparently arm-twisted to appoint a Pharmaceutical Task Force, made up almost completely of industry supporters. The Task Force has now issued a report accusing the Initiative of being "narrow, insular and resistant to meaningful stakeholder engagement," arguing ultimately that the Initiative must be replaced. The Initiative has previously been given high marks in several external reviews and is currently being reviewed by the Faculty of Medicine at UBC.

So what does "insular" and "resistant to significant stakeholder engagement" mean? Apparently for this Task Force it means--independent of the drug industry and those physicians who freely accept its money. The article in CMAJ quotes such international experts as Andrew Herxheimer and Jerome Kassirer as strongly defending the independence and integrity of the Initiative as it now functions.

There may indeed be problems with how the Initiative handles some of its work that require some tweaks in its procedures. As to any basic revisions in the way the Initiative operates, I hope that UBC and the province see through this transparent industry power play, and protect a vital international resource for evidence-based prescribing.

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