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ADHD Drug Debate

My guess is that Ms. Evelyn Pringle does not like the pharma industry because all her investigative reporting is about the evil-doings of pharma. When true, exposing wrongdoing is a good thing, since it will encourage companies to clean up their acts.

I’ll immediately admit that I have worked in the drug industry, have raised issues about some industry practices both when I was an employee and when I became a consultant, and currently work with drug companies as a consultant. For some, this may make me an automatically biased party. I don’t know if I need to argue against that, although I make a point to see both the positive and negative actions that the drug industry has incurred over the years.

In her opinion piece, “Just What Kids Need - Sparlon - Another ADHD Drug” Ms. Pringle does raise legitimate questions about the safety issues and drug trial designs for Cephalon’s drug. Additionally, any attempt on Cephalon’s part to sell the drug “off-label” is illegal and basis for these activities must be scrutinized and investigated. However, one of the experts she cited talked about the conflicts of interest of the authors in the drug trials. The expert said that the authors who did the research had so many affiliations with so many drug companies, “the large number of pharmaceutical company ties with the authors of the study do not lend confidence to the reader even beyond the aforementioned concerns.” I think this conclusion is misleading.

Here’s the fact: If you’re any good at what you do and are considered “influential” by your peers, there will be companies who desire your smarts and advice, and are willing to pay for your expertise. Most of us will think it’s fair exchange to get paid for our time and knowledge as well, which is provides the basis for “employment” or independent “consulting”. The drug industry is no different. It wants to have the best and the brightest physicians in their areas of study to work with the companies’ drugs and let the companies know whether the drugs are any good at all. Usually the best and the brightest physicians see drug companies as manufacturers of some of the most interesting compounds that they want to work with, which motivates many top researchers to reach out to drug companies to see if they can get their hands on the latest compounds in development. When conducted appropriately, this type of collaboration advances healthcare and can help patients who can benefit from the treatment. When conducted inappropriately, collaborations become a guise for kickbacks.

By saying that just because you’ve worked with 10 drug companies you must have sold your soul to drug companies and therefore are incapable of doing any honest science is misleading and an insult to some of these physicians’ reputation. In fact, some physicians make sure they work with multiple companies to ensure that they don’t look like they’re too loyal to just one company. Since most of these physicians care about their reputation (the top thought leaders usually are, being thought leaders and all), they are generally motivated to keep their scientific merit at the forefront of any collaboration - no matter which company.

Of course, there are bad eggs out there, as we have seen in all industries. We have greedy people and dishonest people and just-plain-evil people in our society. They infiltrate all industries including healthcare.

On the other hand, presenting information in a one-sided or biased manner so that you can sensationalize the issue serves few. Entertainment is fine but not at the expense of fair-balanced Patient Education.