Why are the "pharmascolds" still winning the rhetoric war? David Shaywitz's recent piece expands on arguments he's made previously about why it's wrong to demonize interactions between physicians and pharma. But the very nature of his article gets to the heart of the problem - while Shaywitz and others make cerebral, conceptual arguments in favor of doctor-industry collaborations, "pharmascolds" buttress their cases with concrete examples of alleged impropriety and malfeasance in the form of junkets and big-ticket consulting fees. This is a PR problem, pure and simple - pharma companies and their physician collaborators and consultants have worked together to advance health care, but now they need to control and drive the discussion. The demonization of doctor-industry interactions (vividly illustrated by the comments on Shaywitz's recent Atlantic piece) will continue as long as pharma ignores or reacts meekly to public floggings over perceived pharma payola schemes in the media's news sections, editorial pages and book reviews, and fails to provide a counter-narrative.
I realize that bad news sells more newspapers than good news, but still, why haven't we heard more about:
- Preclinical and clinical collaborative research that has led to new drug approvals or indications?
- Productive industry-academia collaborations at the institutional level, and the insights that have emerged?
- Successful government-industry collaborations, like the NCI CRADA program, and their impact?
Admittedly, these examples are more research-oriented than the consulting agreements that often grab headlines - but there are two reasons why they should be publicized more widely. First, although one might think from critics' rhetoric that big-dollar consulting agreements are a dominant form of interaction between industry and physicians, these payments are dwarfed by collaborative research funding. (For example, in 2012 GSK appears to have paid a total of ~$13M to US physicians in consulting fees (based on $3.3M of payments in Q4) compared with almost $85M in collaborative research funding.)
Second, it's important for industry to push back against academic medical centers that lump research collaborations and consulting agreements together as "potential conflicts of interest". There is no question that academic-industry R&D alliances can enhance drug development, and publicizing this impact would do a lot to combat the stigma that currently exists against all forms of physician-industry interactions.
Why has pharma stayed silent on the good that can come from academia-industry interactions? First, it can be hard to identify these collaboration "success stories" unless a company digs deeply into its own data over a long time period - as with all scientific research, it takes many collaborative studies to yield a single result that positively impacts a drug's development. Second, it's hard for outsiders to identify these cases themselves; I spent several fruitless hours online trying to document a recent example of collaboration success I knew of from my current employer, to no avail. But these are no longer viable excuses. If the pharma industry wants to combat negative perceptions around interactions with physicians and academics, companies need to work together to pool their positive examples of how these collaborations can lead to abstracts, papers, insights and ultimately new medicines or new indications for existing ones.
The anti-pharmascold argument is that academia-industry interactions lead to better R&D insights and decisions, and ultimately help patients. It's time to start supporting that argument with data.