by Barry A. Liebling
Recently CBS ran a story about the dangers of statins – drugs that are designed to lower cholesterol in patients who are at risk for heart disease. The CBS story featured a man who had taken a statin and apparently suffered memory loss as a result. The man’s physician did not warn him of the dangers of the drug, and this oversight was attributed partly to the fact that the research supporting the use of statins is funded by pharmaceutical companies. A medical professional who has documented some of the risks of statins was interviewed who contended that her research is valid largely because it is paid for by government funds. The story insinuated that clinical research funded by pharmaceutical companies is suspect, since private companies have an interest in demonstrating that their products are efficacious and safe.
The charge that research funded by pharmaceutical companies is inherently tainted is not new. For several years critics of privately financed medical research have argued that for-profit funding introduces a built in bias against finding the truth. The charge is that researchers are incentivized to please their private-sector patrons. Medical professionals are pressured to conclude that the pharmaceutical product they evaluate works well and has only minor risks. Researchers who find results that are at odds with the expectations of the corporate sponsor will not be hired again – missing the opportunity for future lucrative contracts.
What is really happening? To what extent does privately funded medical research lead to corrupt results?
Consider the case of honest, rational medical investigators. The scientist with the proper ethical orientation knows that his or her primary mission is to discover the genuine effects of the pharmaceutical product – to perform the research proficiently, to interpret prudently, and to report the findings honestly. Personal and professional reputations are on the line. While it is right to be compensated for doing a good job, it is unacceptable to do shoddy work or to be paid for it. Of course, once the results of the research are published it is appropriate for the scientist to disclose fully his or her relevant financial interests. (Parenthetically, I have been a paid consultant to several pharmaceutical companies in my career.) If the medical professional suspects that the motives of the pharmaceutical company are dishonest, the professional should not accept the job in the first place.
What about the pharmaceutical executive who hires the medical scientist? Certainly the executive is hoping that the company’s product will prove to be effective and safe. An independent researcher would not be hired unless the executive had reasons to believe the drug has some real value. And a properly oriented executive wants genuine success, not dishonest fabrications. It is better to know the truth and improve a pharmaceutical product if it falls short than to pretend that it works well and suffer grievous consequences later.
But human beings have free will and do not always choose to act properly. There are some medical investigators who do not have high moral standards – who do not take seriously their mission to perform their job well. While such individuals might respond to monetary incentives, it is not the money but their character that taints their investigations. Similarly, not all corporate executives understand that acting honestly is a necessary condition for genuine success in business. And for these miscreants, it is their work orientation – not that they are employed by a private company – that leads to trouble.
Of course there are commentators who are implacably hostile to medical research being funded by pharmaceutical companies. Their refrain is that the financial incentives companies offer investigators are powerful forces that interfere with the pursuit of truth. If this were true, which it certainly is not, then the adversaries of business ought to be even more suspicious of research that is funded by the government.
Consider the potential for perverting the truth that government funding introduces. If scientists are susceptible to improper influences from profit-oriented clients, they are also vulnerable to the pressures of a government sponsor. Obtaining a government grant is at least as difficult as securing a private contract, and there are strings attached in each scenario. In the government case the sponsor is not concerned with making money but is determined to increase the power of the state and the bureaucrats who run it. Scientists, rather than working for private industry, become the agents of those with the most political pull. If a researcher can be induced by a company to interpret clinical results in a way that makes a product look good, this same researcher will comply with a government sponsor who is intent on showing that a particular product is dangerous – whether it is or not.
In fact, scrupulous medical scientists, whether they are working for the government or for private industry will conduct research properly. Attacks against privately funded medical research are not justified.
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