Citizens Commission on Human Rights International | Mental Health Watchdog

FiercePharma
By Tracy Staton
March 24, 2010

Is the new Journal of the American Medical Association a special issue on reform? It doesn’t stop with its demands for new publication standards. It’s also showcasing a rallying cry from National Institute of Mental Health Director Dr. Thomas Insel, who calls on his fellow psychiatrists to “clean up our act.”

In Insel’s estimation, psychiatry has grown too close to drugmakers. All the money flowing from pharma to psychiatrists and psychiatric researchers has created a “culture of influence,” he says, and psychiatrists need to rise above all that. He wants all financial ties between drugmakers and psychiatry to be disclosed, and for psychiatrists to take a step back from branded meds in favor of generic drugs and non-drug treatments such as talk therapy.

This is far from the first call for change in psychiatry. Over the past three years, congressional probes have repeatedly highlighted influential psychiatrists’ financial relationships with industry. In some cases, payments from drugmakers went undisclosed even though researchers were obliged to report them to their universities.

- read the JAMA extract

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Associated Press
Carla K. Johnson
March 23, 2010

American psychiatrists need to break away from a “culture of influence” created by their financial dealings with the drug industry, the head of the National Institute of Mental Health said in a leading medical journal.

Dr. Thomas Insel stops short of calling researchers corrupt or asking them to stop taking money from drug companies. But he highlights a “bias in prescribing practices” that favors brand names drugs over cheaper generics and non-drug treatments. And he says the situation must change with new standards for transparency and full disclosure of psychiatry’s collaborations with industry.

“We can show the rest of medicine how to clean up our act,” Insel told The Associated Press. His commentary appears in Wednesday’s Journal of the American Medical Association.

His efforts got a boost Tuesday with the signing of the health care overhaul legislation which requires drugmakers and others to file annual reports to the government on their financial ties to doctors. The law requires reporting of gifts, entertainment, food, research money and other fees and grants. Consumer advocates applaud the “sunshine” provision because it also requires a database the public can search for their own doctors’ ties to industry.

“Transparency is the first step toward giving patients and the public the tools they need to evaluate those relationships,” said Allan Coukell, director of the Pew Prescription Project, a consumer health project of the nonprofit Pew Charitable Trusts.

Current National Institutes of Health rules on financial disclosure are confusing, Insel said. They allow researchers seeking federal funds to make their own judgments about what constitutes a significant financial interest, which they must report to their academic or research institutions. The rules also exempt disclosures of anything below $10,000 annually or 5 percent equity interest in a company. Insel is helping oversee a revision of the NIH’s rules, which date back to 1995.

Industry pays for much of the medical research in the United States and many scientists have financial relationships with drug and device makers. Researchers at many institutions are expected to fully disclose those ties to their universities, to the NIH and to the medical journals that publish their research.

Beginning in 2008, an inquiry by Sen. Chuck Grassley, R-Iowa, uncovered millions of dollars in unreported fees paid by drug industry to prominent researchers. The investigation prompted universities and NIH to reassess their conflict-of-interest policies.

When the Grassley inquiry accused seven psychiatrists of failing to report payments they received from drug companies, Insel, himself a psychiatrist, said he tried to determine whether psychiatrists were being targeted unfairly.

He found, instead, evidence that psychiatry may have more drug ties than other medical specialties. In Vermont, for example, which requires public disclosure of industry payments to doctors, psychiatrists receive more money from drug companies than do other types of doctors.

Psychiatric journals report slightly higher rates of industry funding of published studies than other medical journals. And one study found that 90 percent of the advisers who help write American Psychiatric Association guidelines had undisclosed financial ties to industry, Insel writes in JAMA.

Read entire article:  http://www.google.com/hostednews/ap/article/ALeqM5i0eFhYRg8tB3fLeCNO4Ka1IXc_9wD9EKIA103

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