Not all financial interests in drug discovery are detrimental, and many are essential for its success. But focusing on perceived conflicts of interest may cause true scientific corruption to go unnoticed, an opinion expressed in the latest Editorial in Nature Medicine (15, 463 – 464; 2009).
The Editorial describes how a laboratory finding is transformed into a new medicine, involving numerous steps and stakeholders. “In a simple case, a researcher discovers and publishes a new target, and an academic or industrial organization decides to commercialize it. After an initial period of development, this organization licenses the target or a lead compound to a pharmaceutical company with a view to take it to the market. The company sponsors clinical trials, the results of which are also published and evaluated by regulatory agencies that ultimately approve the new therapy for its use in humans. The company then promotes its new product to claim the largest possible share of the market. In an ideal scenario, a postmarketing follow-up of the compound gives the regulators further evidence to evaluate the safety and efficacy of the new medicine.”
Money changes hands many times during this process, at various stages and raising several aspects of competing financial interests. The most negative effect of these, of course, is exposing patients to unsafe drugs. Competing financial interests are handled in a range of ways: some institutions have banned staff from consulting for or from owning stock; laws prevent exchange of gifts between doctors and companies; journals often ask authors to declare fiunancial interests as a prerequisite for publication and may ban scientists who report a financial interest from writing reviews or editorials.
The Editorial goes on to argue that it is seldom acknowledged that not all competing financial interests are equally insidious — some are even necessary for the success of translational research. “Scientists who share their expertise with a company and clinicians who agree to conduct a clinical trial have to be compensated for their work in the same way that every other professional ought to be rewarded for his or her labor. To suggest that they should make their contributions freely is disingenuous, and to argue that they should not get involved at all can only slow the development of new medicines. Academic institutions and their employees must be free to benefit financially from the fruits of the advances made in their laboratories”.
A main fear of competing financial interests is that they could lead to misconduct whenever a researcher has a financial incentive to fabricate data. The Editorial proposes that the focus of concern should move away from whether competing financial interests are publicly declared, and towards exposing and punishing scientific misconduct. …" most financial interests do not represent a conflict as a matter of course and that the influence of money is negative only if it leads to scientific fraud—the one infidel we need to burn at the crusader’s stake."
The full Nature Medicine Editorial, which discusses other aspects of this subject, can be found in the May issue of the journal.