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US doctors urged to refuse industry funds

PMAs in the US should work toward cutting off all funding from pharmaceutical and medical device manufacturers

Professional medical associations (PMAs) in the US should work toward cutting off all funding from pharmaceutical and medical device manufacturers, with the exception of revenues from journal advertisements and exhibit hall fees, according to a call to action in the latest issue of The Journal of the American Medical Association (JAMA).

The change is necessary because PMAs play a key role in medical education through their meetings, publications, journals and CME programmes, and also issue practice guidelines that directly affect patient care, according to the article, co-written by a number of medical leaders, including David Rothman, president of the Institute on Medicine as a Profession, and James Scully, CEO of the American Psychiatric Association.

In the article, the authors call on PMAs to act immediately to restrict total industry support to no more than 25 per cent of their operating budgets for next year, with a long-term goal of refusing funding altogether.

The article also lays out other stringent guidelines, including that leaders and officers of medical associations should receive no personal income or research support from industry during their tenure; associations should never attach names or logos to a commercial product or activity; and research funds from industry should go to a central repository or committee rather than being earmarked for a specific project.

"Industry funding raises vital questions about the standards and operations of PMAs," the authors assert. "How can the public and the profession be certain that a PMA dependent on industry for support is being faithful to its mission of conducting educational programmes and setting practice guidelines that rely only on the best scientific knowledge?"

Responding to the article, Pharmaceutical Research and Manufacturers of America (PhRMA) senior vice president, Ken Johnson argued that: "some of the proposals…could be problematic".

"Like academic medical centres and regional hospitals – which also fund physician educational programmes – PhRMA member companies believe they should contribute to the process by which physicians remain current on the most effective treatment options," Johnson said in a statement.

He also maintains that: "robust codes of conduct already exist," citing among others PhRMA's voluntary code on interactions with healthcare professionals, which was recently revised to decrease conflicts of interests related to CME.

The JAMA article notes that many PMAs have guidelines on conflicts of interest, but that there is significant variation between them and not all are as stringent as they should be.

2nd April 2009

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