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How Conflict-of-Interest Rules Endanger Medical Progress and Cures


How Conflict-of-Interest Rules Endanger Medical Progress and Cures

Richard A. Epstein October 1, 2010
Health PolicyOther

An active partnership between science and commerce underlies Americans' high standard of living, including their state of health and the medical discoveries and treatments that have steadily improved it. But a mounting wariness toward collaborations between employees of research institutions and public agencies and those working for pharmaceutical companies and the like, as expressed in increasingly broad conflict-of-interest rules and prohibitions, threatens to disrupt what has been a wide-ranging and productive exchange of knowledge and information. Populist in its objection to scientists' enrichment and puritanical in its belief in money's certain corruptive powers, this new regulatory philosophy is likely to degrade the quality of research and delay the provision of lifesaving medicines and treatments.

Without carefully weighing the impact of such harms,

  • The National Institutes of Health has forbidden almost all contact between its scientists and those in the private sector. Yet an industry scientist may be the world expert in an NIH scientist's area of research, and others could facilitate the translation of basic research into useful technologies, which is supposed to be one of the agency's goals.
  • The Food and Drug Administration has started demanding extensive public disclosure of the financial ties and payments of experts appointed to committees that review the licensing of new drugs and their accompanying warnings, an encroachment on their privacy they are sure to find distasteful. It does so despite the fact that a third of these positions are unfilled.
  • Universities have become leery of cooperation with drug companies out of concern to preserve the single-mindedness of pure research. Yet they do not hesitate to patent fee-producing devices invented in their laboratories with federal financial assistance, as 1980's Bayh-Dole Act permits them to do.
  • The parent organization of two Harvard-affiliated hospitals has placed strict limits on per diem compensation for service on corporate boards, which only encourages physicians to devote more time to activities beyond their hospital duties.
  • Leading medical societies are considering whether to prohibit their physician members from accepting fees from drug companies to inform medical audiences about medicines the companies are marketing. Yet such presentations occur before informed, professionally skeptical audiences that may contain representatives of competitors well-equipped to contradict false or misleading claims.
  • Massachusetts has enacted the Pharmaceutical and Medical Device Manufacturer Conduct Act, which imposes a sweeping prohibition against gifts, including training sessions, from such businesses. The net effect, however, will be to move such valuable activities beyond the state's borders.

Such censoriousness rests on at least two questionable assumptions; first, that parties with some kind of financial interest, however trivial, are, inevitably, purveyors of bad information; and second, that reliance on information from such sources, or even on information that is actually bad, is worse than an absolute reduction in the amount of available information, which occurs when industry sources are closed off.

Except in egregious cases, conflicts of interest are a necessary part of doing business in an interconnected world. These conflicts can be managed through a judicious combination of disclosure and oversight. Severe and broad conflict-of-interest regimes sweep before them even highly regarded, well-motivated professionals, denying society the benefits of the knowledge they possess.