If They Took Pharma Money, Should We Still Respect Them in the Morning?

Posted by Mark Abramowicz, M.D.

An article in the July 5 Wall St. Journal skewers a physician who, according to the Journal, took $275,000 from a pharmaceutical manufacturer and then said something positive on the radio about an off-label use of one of the manufacturer’s drugs. Does it matter that what he said (in effect, that buproprion does not have the sexual side effects of an SSRI) is generally accepted as true? Apparently not, or at least the Journal does not mention it, and GlaxoSmithKline recently paid the US government $3 billion to settle claims of illegal marketing of off-label uses of bupropion, among other charges.

Now we are preparing an article for publication in The Medical Letter on a subject that means a great deal, financially speaking, to several pharmaceutical manufacturers: What should be the second drug used to treat patients with type 2 diabetes who have not responded adequately to metformin? The standard choice has generally been a sulfonylurea such as glimepiride, but the side effects of these agents have become an increasing concern as newer alternatives have become available. In June 2012, The Lancet published 3 separate clinical trials of drugs for this indication. The one sponsored by Sanofi favored the use of insulin glargine (Lantus – Sanofi); the one sponsored by Amylin found exenatide (Byetta – Amylin) more effective and safer than glimepiride; and the one sponsored by Boehringer Ingelheim found linagliptin (Tradjenta – Boehringer Ingelheim) noninferior to, and safer than, glimepiride.

Are those results entitled to the same respect as data from studies not sponsored by industry? We’ll have to think about that in the morning.

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