Physicians much less willing to prescribe drugs tested in pharmaceutical-industry funded trials, study finds

October 9, 2012 by Alexis Blue

(Medical Xpress)—Physicians are less likely to trust the results of clinical trials when they know those trials were funded by pharmaceutical companies, regardless of the quality of the research, a recent study in the New England Journal of Medicine shows.

The study, led by Dr. Aaron Kesselheim of the Harvard Medical School in Boston and co-authored by University of Arizona associate professor of law Christopher Robertson, evaluated ' confidence in the results of drug trials conducted with a high, medium or low level of methodological rigor. It then looked at how their confidence in those same results changed when a trial's funding source was revealed as either the National Institutes of Health or a company in the pharmaceutical industry, versus when no funding source was disclosed.

When presented with fictitious clinical trials of varying quality and no funding source identified, physicians said they would be most likely to prescribe drugs tested in high-rigor trials, slightly less likely to prescribe drugs from medium-rigor trials and least likely to prescribe drugs from the least rigorous studies.

However, when funding sources for those same studies were revealed, doctors' confidence in the results changed, with physicians being about half as willing to prescribe drugs tested in funded than those in NIH-funded studies. That was true no matter how high quality a trial's methods.

The study was designed to explore physicians' perceptions of industry-funded science following a string of high-profile scandals in which were found to have manipulated research in order to get or to get it marketed more broadly after approval, Robertson said.

What was revealed has both positive and negative implications, Robertson said.

"It was good news, bad news. On the one hand, doctors seemed to be really to the methods in evaluating a high-quality study or a medium-quality or a low-quality study, so that was our first big finding – that physicians seem to be sophisticated, intelligent consumers of science. They're not just looking at the bottom line; they are distinguishing between a high-quality study or a low-quality study," Robertson said.

On the other hand, the fact that physicians severely discounted even good science when it was funded by industry raises some concerns, Robertson said.

"If a study is both poorly designed and industry funded, then you really worry that there's chances for biased outcomes. But if it's really a well-designed, double-blinded, large sample study, there are fewer opportunities for industry to bias the results. But we saw physicians discounting across the board for industry funding," he said.

It is fine to be skeptical of industry science, Robertson said. The problem, he said, is that physicians often have nowhere else to turn for science on new drugs and devices, since the majority of today's biomedical research is funded by industry.

"The National Institutes for Health funds less than one-third of the science and will likely fund less and less going forward as we cut the federal budget," Robertson said. "We need to figure out a way forward where we can have science be done well and be credible."

Robertson said the study reveals what he calls "a crisis in confidence."

"We're in this situation where physicians need to rely on science to move medicine forward to make us healthier and to provide health care more efficiently, but physicians don't have science that they feel they can really trust," Robertson said. "I'm concerned that we are ending up in a situation of general skepticism that's really not good for anyone. It's not good for the industry because they can't sell drugs even when they're high quality, and it's not good for patients because when you do have a good drug, physicians are slow to change their practices to use it."

This "crisis in confidence" is among the challenges in translational medicine, or the process of getting new science to reach the bedside, Robertson said.

"Changing the culture of medicine can be slow going," he said, "and this lack of confidence in new scientific research is another reason why that's difficult."

Explore further: Can disclosure hurt the translation of research?

Related Stories

Can disclosure hurt the translation of research?

September 19, 2012
All major clinical trials now include disclosures detailing who funded the study to ensure transparency. However, is it possible that this transparency is actually hurting research? One might assume that the methodological ...

Positive outcome no more likely in industry-funded trials

July 5, 2012
(HealthDay) -- Industry-sponsored clinical trials of rheumatoid arthritis drugs are no more likely to report positive outcomes than trials funded by other means, and in many cases use better methodology, according to research ...

5 Questions: Ioannidis on the need to test medical 'truths'

January 6, 2012
(Medical Xpress) -- How many established standards of medical care are wrong? Disturbingly, no one knows for sure, but one study suggests that it could be almost half, according to a commentary published in the Jan. 4 issue ...

Recommended for you

Study suggests ending opioid epidemic will take years

July 20, 2017
The question of how to stem the nation's opioid epidemic now has a major detailed response. A new study chaired by University of Virginia School of Law Professor Richard Bonnie provides extensive recommendations for curbing ...

Team-based model reduces prescription opioid use among patients with chronic pain by 40 percent

July 17, 2017
A new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40 percent, according to a new study out of Boston Medical Center's Grayken Center for Addiction Medicine, which ...

Private clinics' peddling of unproven stem cell treatments is unsafe and unethical

July 7, 2017
Stem cell science is an area of medical research that continues to offer great promise. But as this week's paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, ...

Popular heartburn drugs linked to higher death risk

July 4, 2017
Popular heartburn drugs called proton pump inhibitors (PPIs) have been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. Now, a new study from Washington University School ...

Most reproductive-age women using opioids also use another substance

June 30, 2017
The majority of reproductive-age and pregnant women who use opioids for non-medical purposes also use at least one other substance, ranging from nicotine or alcohol to cocaine, according to a University of Pittsburgh Graduate ...

At-risk chronic pain patients taper opioids successfully with psychological tools

June 28, 2017
Psychological support and new coping skills are helping patients at high risk of developing chronic pain and long-term, high-dose opioid use taper their opioids and rebuild their lives with activities that are meaningful ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.