Doctors with links to drug companies influence treatment guidelines

Doctors with financial ties to drug companies have heavily influenced treatment guidelines recommending the most lucrative drugs in American medicine, an analysis by the Milwaukee Journal Sentinel and MedPage Today has found. 

 The guidelines affect how doctors across the country treat patients for everything from diabetes to asthma, chronic pain, depression and high cholesterol. 

 Issued by leading medical associations and government institutions, treatment guidelines are supposed to be based on rigorous science. But the committees that write them have been dominated by doctors who have worked as paid speakers, consultants or advisers for companies selling the recommended drugs. 

 Critics say the financial relationships have corrupted medicine, resulting in cases where guidelines make dangerous or ineffective recommendations. Drug companies and some doctors counter that those with conflicts are often top experts in their field. 

 The Journal Sentinel examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the United States. 

 The drugs sit in the medicine cabinets of millions of Americans - Nexium for acid reflux, Lipitor for high cholesterol, Cymbalta for depression and OxyContin for pain. Their collective sales topped $94 billion in 2011, accounting for 30% of drug revenue in the United States. 

 An analysis of the guideline panels, which involved 293 doctors, found:

• Nine guidelines were written by panels where more than 80% of doctors had financial ties to drug companies.

• Four panels did not require members to disclose any conflicts of interest. Of the 16 that did, 66% of doctors on the panels had ties to drug companies.

• Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing. Medical experts have raised such questions about guidelines for anemia, chronic pain and asthma.

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