The Pharmaceutical Journal
Vol 275 No 7372 p505
22 October 2005

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Most US guideline panels have conflicts of interests

One in three academics and doctors who write clinical practice guidelines have a financial interest in the drug company associated with the drugs they recommend, according to the results of a US survey published this week in the journal Nature (2005;437:1070).

Researchers discovered that there was a conflict of interest in nearly 70 per cent of the panels they surveyed.

Commenting on the findings, the deputy editor of JAMA, Drummond Rennie, who is campaigning for clinical guidelines to be free from the influence of the industry, said:

“The numbers in the survey are distressing. The practice stinks.”

The survey revealed that of 685 authors questioned, 445 (65 per cent) said they had no conflict of interest. But 21 per cent (143) admitted they held a consultancy position for the drug company involved or sat on an advisory board. Another 22 per cent (153) revealed they had received research grants from the drug company, and a further 15 per cent (103) had other links.

Only 2.3 per cent or 16 authors owned drug company stock. But researchers found that every member of one clinical guideline panel had been paid by the company that was behind the drug that the guidelines recommended.

The survey results were based on all guidelines given to the US national guideline clearing house in 2004. The researchers revealed that, overall, 49 per cent of the clinical guidelines involved in the survey did not include any details of any panel members’ potential conflict of interest.

A spokesman for the Association of the British Pharmaceutical Industry said there is nothing in the UK that is equivalent to the US clinical practice guidance panels.

He said: “The nearest thing in the UK to clinical guidance practice panels are the various advice bodies, the British National Formulary and the National Institute for Health and Clinical Excellence health technology assessments. These are all totally independent organisations.”

A spokesman for NICE, which produces clinical guidelines for the NHS in England and Wales, told The Journal that NICE had a conflict of interest policy in place. He explained that each clinical guideline produced by NICE had an associated guideline development group, each with its own rules dictating who could and who could not sit on the group. However, he added that it was important that NICE took the views of the pharmaceutical industry into account when developing guidance and that industry representatives would therefore sit on NICE committees. “Those who are not representing industry have to declare any conflict of interest,” he said.