Quit smoking with Chantix says UW course

An article by the Associated Press notes that: “In a drastic proposal for limiting drug company influence on doctors and patient care, a group of prominent physicians says medical associations and their leaders should reject almost all industry funding.”

I’ve written a couple of posts over the past year about the growing influence of the pharmaceutical industry on medical research and unreported conflict of interest by some medical professionals. But a Milwaukee, Wisconsin newspaper points out just how pervasive the practice has become.

The Journal-Sentinnel reported that “drug companies have largely taken over the field of doctor education, in part by bankrolling physician education courses at medical schools.” The drug industry spent $1.2 billion on such courses in 2006 according to the Journal of the American Medical Association, funding more than half of all such courses.

"Drug companies have essentially hijacked the highest level of medical education we have in this country," said Daniel Carlat, an associate clinical professor of psychiatry at Tufts University Medical School.

Journalists Susanne Rust and John Fauber found that, among other things, an online doctor education course offered at the University of Wisconsin (UW) recommended the use of the smoking cessation drug Chantix (sold in Canada as Champix). The drug has been linked to serious side effects, including suicidal ideation, and may have contributed to 3,325 serious injuries and 112 deaths in the U.S. Both the US FDA and Health Canada have issued advisories concerning the drug.

But mention of the side effects wasn’t evident in the online course materials.

Drug companies like Pfizer, spend about $13 million a year to fund UW medical education courses, with the university receiving over $3 million of that money. The remainder of the funding goes to private firms that develop the course material.

Courses funded by the pharmaceutical industry are offered free at UW, making them attractive to physicians required to earn continuing medical education credits.

In addition to recommending Chantix, the course promotes a reliance on pharmaceutical aids as the only reliable means to smoking cessation, despite having a very dismal long term success rate of roughly 2%. No consideration is given to simply quitting “cold turkey”, despite considerable evidence that it is a far more successful method than nicotine replacement therapy.

Dr. Michael Siegel of Boston University School of Public Health, took the course even though he’s an expert in the field of tobacco control. Apparently, he wanted to get a feel for the course material for an article which appeared on his blog.

Says Siegel: “I discovered that the course relies heavily upon and frequently cites as documentation, the recommendations of an NIH (National Institute of Health) expert panel on smoking cessation. However, nowhere is it disclosed that the chair of the panel and eight of its members had financial conflicts of interest by virtue of their financial ties to Big Pharma”.

In fact, the only source of information and guidance for the course appears to be from the guidelines established by the expert panel, which may have been heavily influenced by the financial connection of numerous members of the panel with the pharmaceutical industry.

But, if drug company influence on doctors, and in turn on patient care, is so pervasive, how can the public fully trust in the treatment being proscribed by their physicians?

If the writers of treatment guidelines can be influenced by financial ties with the drug industry to recommend a certain course of treatment, or prescribe a certain medication, the biggest winners are likely be the drug companies.

And, if doctors' continuing education classes are based on treatment guidelines, quite possibly biased by financial conflict of interest, how can even doctors be assured they are giving their patients the best medical advice available?

Dr. Steven Nissen, one of 11 co-authors of the proposal to limit drug company influence, and a former president of the American College of Cardiology noted that: "It has not always been flattering to see how physicians' relationships to industry appear to have colored their judgment in matters of public health."

The proposal is not expected to go far. Said one doctor; “it's unlikely to be fully adopted by large medical groups which depend on industry funding for many activities”. Uh-huh.

The truth is the pharmaceutical industry, in large measure, has funded the research that has defined the tobacco “problem”. They have funded the research and developed the drugs meant to resolve the problem. They have heavily funded the anti-smoker movement, whose activities promote smoking cessation and the need for drug company products.

And, drug industry dollars are influencing medical treatment guidelines, continuing education courses for doctors and therefore, indirectly, the course of treatment being recommended to patients.

They do none of these things for the good of humanity. Like the tobacco companies before them, they expect a return on their investment.