The New England Journal of Medicine will announce Thursday
that it has given up finding truly independent doctors to write and
review articles and editorials for it, as a result of the financial ties
physicians have with so many drug companies in the United States The
Journal says the drug companies' reach is just too deep.
In 2000, the drug industry sponsored more than 314,000 events for
physicians everything from luncheons to getaway weekends at a cost
of almost $2 billion. On top of that, many doctors accept speaking and
consulting fees that link them to drug companies.
No publication in this country influences the way your doctor treats
an illness more than the New England Journal of Medicine. Since
1812, the Journal has scrutinized and published thousands of
These "review" articles on drug therapy that can be pivotal. They
tell doctors the strengths and weaknesses of new medications for
everything form high blood pressure to obesity to cancer.
Now, the Journal will allow these critical evaluations to be
written by people with financial ties to drug companies.
"This change will allow us to recruit the best authors, the people
who have experience with new treatments to write these editorials and
review articles," said Dr. Jeffrey Drazen, the medical journal's
Under the new policy, doctors writing reviews in the Journal
can accept up to $10,000 a year from each drug company in speaking fees
and consulting fees.
Concerns About Possible Bias
Not everyone thinks this is such a good idea.
"So if a doctor is doing that kind of business with four or five
companies, he or she can get as much [as] $40- to 50,000 a year and not
violate the new New England Journal policy," said Dr. Sidney
Wolfe, the director of the Public Citizen Health Research Group, one of
the country's largest medical consumer groups.
"The bias introduced by drug companies paying writers of review
articles a large amount of money can have the consequence of slanting
articles and influencing physicians in a way that isn't really in the
best interests of their patients," said Wolfe.
The Journal, in a letter to its readers, says the policy
change is necessary because it simply could not find enough qualified
authors who did not already have ties to drug companies.
"There are areas where we simply have not published anything because
we didn't think we could get a person who was good to write in an area
that had absolutely no interaction with a commercial entity," said
But Jerome Kassirer, who was the Journal's editor between 1991
and 1999, says he had no problem finding independent authors.
"There's a lot of depth in academic medicine, sufficient depth, so
that it's almost always possible to find a first-class person to write
an editorial or review article in which they do not have a conflict of
interest," said Kassirer, now a professor at the Tufts University School
Some doctors are concerned that by relaxing conflict-of-interest
standards, the Journal is reducing the prestige and influence
that it has taken 190 years to build.