Anatomy of an Industry: Commerce, Payments to Psychiatrists and Betrayal of the Public Good

This article by Robert Whitaker has been written within an America context (but with wider applicability) and has been published by Mad in America. It begins:

“The 2013 federal Open Payments legislation, which requires pharmaceutical companies to disclose their direct payments to physicians, was expected to help counter the corrupting influence of such payments. If the payments became public, the thinking went, medical school faculty would shy away from serving as the named authors on ghostwritten papers reporting clinical trial results, and they would refrain from being paid to give promotional talks as companies built markets for their newly approved drugs.

The Centers for Medicare and Medicaid Services recently published the 2020 payments, and thus there is now a seven-year record of payments that can be easily accessed. A Mad in America investigation of these records reveals that while the legislation has indeed reduced the participation of academic psychiatrists in these activities, the corrupting influence of pharmaceutical money on all phases of the drug development process—the testing of drugs, the reporting of results in journals, and the selling of newly approved drugs to the medical community—is ever-present. The corruption today is more entrenched than ever.

In psychiatry, there now exists what could be described as a psychopharmacology service industry, which can be divided into three sectors. There are a small number of academic psychiatrists who serve as consultants and advisors to companies as they run their phase II and phase III trials, and, together with company employees, serve as authors on the published reports of those studies. There is a second, somewhat larger group of psychiatrists who write further reviews of the phase II and phase III results, and by doing so help promote increased awareness of the new drugs. The third sector helps market the drugs to prescribers. Psychiatrists from the first two groups speak at conferences and serve as ‘faculty’ for continuing medical education courses, and their efforts are complemented by a much larger number of community psychiatrists that populate the dinner circuit …”

You can read more from here.

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