University Diaries » “The old model was Pfizer hires Joe. The new model is Pfizer hires the entire department of biochemistry… I don’t see that being managed by disclosures of any sort.”

Don’t ban conflicts of interest; manage them, say universities and journals, which means disclosing such conflicts. Yet there’s “ritual ignoring of disclosures,” writes one observer, which makes them public-relations terrific and actual-world pointless.

Harvard’s Eric Campbell notes that

A lot of medical schools have made the decision that speakers bureaus are inappropriate and they have banned them… A lot of institutions have said our doctors are not going to take tickets to football games, go out to eat with drug companies, or accept other incentives.

But there’s the business of whether pharma-compromised researchers should be able to publish in reputable journals. That, and perks beyond football and dinner, continue to be worked out, one campus at a time.

But do not forget the larger context of these debates. They’re not just about the obvious fact that you’re more likely to skew evidence in the direction of people shoveling money at you; they’re about a zillion dollar industry that takes regular multi-million-dollar judgments against it for manifold violations of the law totally in stride; direct-to-consumer advertising that creates stupendous pressure to substantiate claims about this or that disorder; institutional rewards that are all about prolific publishing; pharma-paid ghostwriting agencies that may write the entire article for you, etc., etc. Conflict of interest is not simply a particular problem for particular American universities. As Art Caplan’s comment in this post’s title suggests, it’s a structural problem that has occurred because pharma is now so rich it can buy entire university departments.

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