As Healthcare Reform develops and shape regulations within the healthcare industry, unethical practices and conflicts of interest in the pharmaceutical industry affirm the need for transparency and improved traditions. Conflict of interest from a legal standpoint is “a conflict between the private interests and the official or professional responsibilities of a person in a position of trust.” (Merriam-Webster’s Dictionary of Law, 2010) From a business perspective, conflict of interest is defined as a “situation that has the potential to undermine the impartiality of a person because of the possibility of a clash between the person’s self-interest and professional-interest or personal-interest.” (BusinessDictionary.com)
With the number of physicians operating private practices in the United States, the clinical drug trial kickbacks have become common practice and the ravenous patterns have been explicitly revealed. The frequency of such behaviors and exposure of financial gain are enough to further strengthen the necessity for health care reform. Each unscrupulous circumstance that is exposed brings about further insight to the widespread unethical conduct of the pharmaceutical industry. There is an abundance of scenarios and examples depicting behaviors as well as emergent methods to circumvent such conflicts of interest. Additionally, laws and processes are in place to further develop and establish parameters around acceptable and unacceptable practices for both pharmaceutical manufacturers and physicians alike. With the objective to deter, eliminate and expose conflicts of interest, various projects, acts and charitable trusts have been developed and comprised of committees of citizens, organizations, and donors who vigorously advocate patient safety through improved changes in the manufacturing and marketing of prescription drugs.
So how does conflict of interest play a role in clinical drug trials? When discussing conflict of interest as it relates to clinical drug trials the scenario is usually one in which a researcher has a monetary rapport and research money, with the company that manufacturers the drug being studied. There is nothing fundamentally erroneous with these types of conflicts of interest, they are practically everywhere within drug trials because most of the trials are financed by the drug companies that produce the drugs being studied.
In an article written by John H. Montgomery related to the examination of conflicts of interest, research was done by Dr. Roy H. Perlis on the outcome of drug trials and the relationship that the author or industry has to that outcome. Research shows that 397 trials were reviewed and of those, 162 random trials yielded positive results that were funded by the manufacturer of the drug being studied. These results give indication that conflict of interest is common and associated to the outcome of the trials. This is just one of many examples of how common conflicts of interest arise in the healthcare industry. Another study conducted “looked at randomized controlled trials of NSAIDs (non-steroidal anti-inflammatory drugs) between 1987 and 1990” (Bodenheimer). This study found that relatively all of the trials in the three-year span were sponsored by the drug producer. The research also discovered that the drug being compared to the manufactured drug was equivalent in efficiency and in some cases was even better than the manufactured drug in every trial. The study also reported that “the manufacturer-associated drug was safer than the comparison drug in 86% of the trials” (Bodenheimer). Remember, these trials were funded by the drug companies sponsoring the trials.