[e-drug] Conflict of interest when dual positions in academia and industry (2)

["Leo Offerhaus" <offerhausl@euronet.nl>]

E-DRUG: Conflict of interest when dual positions in academia and industry (2)
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Dear colleague(s),

There is no simple answer, because a full "NO" is theoretical. It all 
depends on the definition of clinical pharmacology, and if, with the 
1971 WHO report, one defines it as a medical speciality, then  it 
should have three functions: (a) patient care, (b) teaching and (c) 
research. The number of persons with sufficient knowledge and 
expertise in this field is extremely limited, and, as worldwide 
research funds are drying up, industry has become one of the main 
sources of money. It is therefore almost impossible to find a 
clinical pharmacologist who has never accepted - either personally or 
for his work - money from industry. If such persons exist they are 
lying or they have rarely published anything worthwhile, except 
perhaps some second-hand "pharmapolitics" or epidemiological 
research. It is the same with gouvernment officials or members of 
registration committees; certainly the great majority of clinicians 
with expert knowledge have been or are involved in industry-funded 
research. But what is absolutely necessary is that such transactions 
should be 100% transparent and all data accessible in the public 
domain. In addition any personal gains should be avoided and any 
income from such sources should be administered by the hospital, the 
university or any related public institution. To my opinion that also 
applies to foreign travel and conference attendance, even if its 
means that a poorly funded archaeologist from the same university 
might also profit. There is no reason why a cardiologist should 
travel first class and sleep in a five-star hotel when his colleagues 
doing fundamental research stay at a youth hostel. Many people forget 
that income from medicines is - apart from the unavoidable expenses 
made by the industry - public money paid by tax payers. Medicines are 
not consumption articles like TV sets, cars or luxury foods.

So in principle funding drug research by industry should be OK, but 
on certain conditions which should be accurately laid down. Any 
research worker who wants to cheat will do so, whether funded from 
outside sources  or not. It is the responsibility of universities and 
institutions to attract people with the highest standards and 
supervise both the economical and the research aspects.

An exception should of course be made for civil servants involved in 
drug registration and inspection. They should at all costs remain 
free from any ties with industry because their only responsibility is 
the defence of public and individual patient health and any deviation 
from this principle should be regarded as corruption.

I hope that I have made clear to clinical pharmacologists or related 
persons that there is a fundamental difference between the ideal 
world of principled opinions and what happens in the real world. 
Prohibition is not an option, regulation is.

Best wishes,

Leo Offerhaus, 
the Netherlands.
offerhausl@euronet.nl

[the moderator agrees that 'no' might be theoretical and that regulation and transparency are the key words].