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I applaud Carl Eliott’s recent article “The Secret Lives of Big Pharma’s ‘Thought Leaders”– I think it’s a well written article that draws in the reader and pulls them into a narrative. It’s an accessible article even for laymen to learn a bit about the mechanics of how medical experts are integrated into drug development and marketing cycles.
Unfortunately, it leads them down a solitary – and potentially biased – pathway to conclude that the relationship between academic institutions and the business community is a bad thing. Elliot writes, “Universities could easily clean up the problem, simply by banning or capping industry payments.” Yet he opines “that is unlikely to happen,” and further implies that it’s “because academic physicians would object “ and “many high-level university administrators have lucrative corporate relationships.” Most damaging, he leads the reader to believe that all pharmaceutical thought leaders have secret lives pretending to be a medical experts.
Wow, is that not a “scorched earth” view? Perhaps it’s such a stark view solely aimed to create controversy for the sake of promulgating discussion.
Could you imagine a world where academic research is segregated and isolated from business? A place where business could not hire an expert to evaluate the efficacy of a new product, or ask for help putting a newly discovered invention into production? A world where a scientist could not leave academia to start a new company, or verify that her invention has a wider application?
No matter what the pharmaceutical industry calls them – Thought Leaders, Key Opinion Leaders, External Experts – they are all External Subject Matter Experts that provide advice and services. Under Eliott’s logic, is it not the same “influence peddling” when a government convenes and compensates through a grant or award a panel of experts to develop Disease Treatment Guidelines? Are these panels not selling their opinion on what is appropriate?
It’s not an easy answer, and it’s not a debate that is likely to die down soon. Merely skimming through the Comments on Elliott’s posted article reveals a passionate set of opinions by academics and medical professionals. Regulations continue to be handed down to restrict abuse of influence, and pharmaceutical companies struggle with flux, caught between their needs and a muddy lens of regulatory requirements. If, in the end, academic researchers are fully cut off from their relationships with pharmaceutical companies, I believe the outcome would not be advantageous to the public at large who have come to depend on the private pharmaceutical industry to drive innovation in treating their diseases.
