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Interessenskonflikte in der Medizin

1. [lo10a] Lo B: Serving two masters – conflicts of interest in academic medicine. N Engl J Med. 2010 Feb;362(8):669-71. PMID 20181969, doi:10.1056/NEJMp1000213. PDF. Deutsche Übersetzung
   University of California, San Francisco, San Francisco, USA.
2. [jelinek09] Jelinek GA, and Neate SL: The influence of the pharmaceutical industry in medicine. J Law Med. 2009 Oct;17(2):216-23. PMID 19998591. Abstract, PDF, Deutsche Übersetzung (PDF)
   Department of Medicine, University of Melbourne, St Vincent's Health, Fitzroy, Victoria, Australia.
   Abstract

   Pharmaceutical companies are known to be amongst the most profitable companies in the world. Proceedings of legal cases and published research provide insights into the nature of the influence of drug companies into research and publication practices relating to the drugs they manufacture, marketing disguised as ‘education’ and their influence on doctors who prescribe their drugs. The influence of drug companies extends further to sponsorship of opinion leaders promoting their drugs and groups producing clinical guidelines. More rigorous regulation of the relationship between the industry and medicine is required.
   About Prof. Jelinek

   My mother died of MS in 1981. Towards the end of her life, she was totally incapacitated, unable to feed or care for herself. I was diagnosed with MS in 1999. I was determined that this was not going to be my fate. Fortunately, my career as a Professor in Emergency Medicine and background as Editor-in-Chief of a major medical journal gave me the tools to sort through the medical literature on MS, giving appropriate weight to the various pieces of evidence I found. [Source]
3. [lo09a] Lo B, Institute of Medicine (U.S.): Conflict of interest in medical research, education, and practice. Washington D.C.: National Academies Press; 2009. Book (Online)
   Description

   Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine.

   Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome.

   Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.

   Definition: Conflicts of interest are defined as circumstances that create a risk that professional judgments or actions regarding a primary interest will be unduly influenced by a secondary interest.

4. [klemperer09a] Klemperer D: Interessenkonflikte und Beeinflussung. [Conflict of interest and adaptation] Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2009;103(3):133-135. PMID 19554886, PDF
   Hochschule Regensburg, Fakultät Sozialwissenschaften, Regensburg, D
5. [rothman09a] Rothman DJ, McDonald WJ, Berkowitz CD, Chimonas SC, DeAngelis CD, Hale RW, Nissen SE, Osborn JE, Scully JH, Thomson GE, and Wofsy D: Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest. JAMA. 2009 Apr;301(13):1367-72. PMID 19336712, doi:10.1001/jama.2009.407.
   Institute on Medicine as a Profession, Columbia College of Physicians and Surgeons, 630 W 168th St, New York, NY 10032, USA.
   Abstract

   Professional medical associations (PMAs) play an essential role in defining and advancing health care standards. Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflict of interests. Any threat to the integrity of PMAs must be thoroughly and effectively resolved. Current PMA policies, however, are not uniform and often lack stringency. To address this situation, the authors first identified and analyzed conflicts of interest that may affect the activities, leadership, and members of PMAs. The authors then went on to formulate guidelines, both short-term and long-term, to prevent the appearance or reality of undue industry influence. The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps, to forgo valuable activities. To maintain integrity, sacrifice may be required. Nevertheless, these changes are in the best interest of the PMAs, the profession, their members, and the larger society.
6. [finzen07a] Finzen A, Fritze J: Behindert Sponsoring den Erkenntnisprozess in der Medizin? [For and against: does sponsoring impede the growth of knowledge in medicine?] Psychiatr Prax. 2007 Mai;34(4):162-164. PMID 17520527, doi:10.1055/s-2006-951952, Article, PDF
   Basel; Köln
7. [moynihan08a] Moynihan R: Key opinion leaders: independent experts or drug representatives in disguise? BMJ. 2008 Jun;336(7658):1402-3. PMID 18566074, doi:10.1136/bmj.39575.675787.651, Article.
   University of Newcastle, Newcastle, New South Wales, Australia.
8. [angell05a] Angell M: The Truth About the Drug Companies. How They Deceive Us and What to Do About It. Random House Trade, New York, 2005. books.ch amazon.de ; Deutsche Übersetzung: ''Der Pharma-Bluff'', Marcia Angell, books.ch amazon.de.
   Abstract

   During her two decades at The New England Journal of Medicine, Dr. Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.

   Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.

   Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.

   The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.

9. [hinchliffe05] Hinchliffe D, Amess D, Austin J, Bradley K, Burns S, Calton P, Dowd J, Owen J, McDonagh S, Naysmith D, and Taylor R: The influence of the pharmaceutical industry. House of Commons Health Committee, Fourth Report of Session 2004–05, Volume I. PDF
   House of Commons, Parliament of the United Kingdom
10. [moynihan02a] Moynihan R, Heath I, and Henry D: Selling sickness: the pharmaceutical industry and disease mongering. BMJ. 2002 Apr;324(7342):886-91. PMID 11950740. PDF.
    Australian Financial Review, GPO Box 506, Sydney, 2201, Australia.
11. [angell00a] Angell M: Is academic medicine for sale? N Engl J Med. 2000 May;342(20):1516-8. Type: Comment. PMID 10816191, PDF.

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