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It should be obvious that patients need unbiased advice when it comes to making decisions that can impact their health.

With that in mind, it stands to reason that physicians and scientists with financial ties to the drug industry should not be permitted to participate in broad policy and public health recommendations. But this is exactly what happens, and it happens more or less routinely.

In fact, conflict of interest is rampant in the field of medicine, even when it comes to recommendations from supposedly independent authorities like the federal government, which makes it very difficult to trust conventional health advice.

This issue was recently highlighted in a study published in the
Milbank Quarterly,1 a multidisciplinary journal of population health and health policy.

The author, Genevieve Pham-Kanter, reviewed how financial interests affected the voting behavior of nearly 1,400 Food and Drug Administration (FDA) advisory committee members who took part in the decision process for Center for Drug and Evaluation Research between 1997 and 2011.

FDA advisory committees are created to help the agency make approval decisions on drugs, and the presence of external experts is supposed to ensure that decisions are unbiased and grounded in sound science. Alas, Pham-Kanter’s findings show this system can result in significant bias when conflicts of interest are ignored, as they typically are.      

Conflicts of Interest Rampant Among FDA Advisors

In all, the 1,400 FDA advisory committee members cast nearly 15,740 votes between 1997 and 2011. After carefully examining the financial relationships between these committee members and drug makers, Pham-Kanter’s study2 showed that:

• On average, 13 percent of the members in any given committee had financial interest in the company whose drug was up for a review by that committee.     

• About one-third of financial interests involved consulting for a drug maker; 25 percent involved ownership interest; 14 percent involved serving on an industry advisory board or steering committee.     

• Committee members with financial ties to the company sponsoring the drug under review voted in favour of approval 63 percent of the time, while members who did not have financial ties had a 52 percent chance of favouring approval.     

• Committee members who served on a sponsoring firm’s advisory board had a whopping
84 percent chance of voting in favour of the drug’s approval.     

• Committee members with financial ties to several competing drug firms did not, on average, show pro-industry bias in their voting behaviour.