Conflict of interest in the healthcare industry

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Conflict of interest in the health care industry occurs when the primary goal of protecting and increasing the health of patients comes into conflict with any other secondary goal, especially personal gain to healthcare professionals, and increasing revenue to a healthcare organization from selling health care products and services. The public and private sectors of the medical-industrial complex have various conflicts of interest which are specific to these entities.

Trends

There is a lack of empirical evidence to describe the impact of conflict of interest in the health care industry.[1]

Business interests influence the direction of cancer research and the adoption of new practices in therapy.[2]

University projects which receive industry funding are more likely to produce research outcomes which favor their funders.[3]

A 2017 systematic review by the Cochrane Collaboration found that pharmaceutical and medical device industry sponsored studies are more often favorable to the sponsor's product compared with studies with other sources of sponsorship.[4]

The trend toward treating clinical research as a business has coincided with a range of problems which are likely the result of business connections.[5]

Funders seek and court scientists to author papers and lend their person reputations to add credibility to research findings.[6]

Physicians in general practice also face potential conflicts of interest.[7] For example, the Physician Payments Sunshine Act of 2010 requires that financial relationships of physicians and teaching hospitals with manufacturers be reported and made publicly available via the Open Payments Program website.

Using this Open Payments database, it was found that about 64% of US-based physician-editors of highly cited medical journals received industry-associated payments (i.e., payments from medical drug and device companies) during a period spanning August 1, 2013 to December 31, 2016.[8]

Medical journals have varying requirements what should be published and people who fail to follow them face few repercussions.[9]

The medical-industrial complex describes the conflict of interest present between physicians and the healthcare industry.[10] Physicians who invest in medical device companies may be biased towards certain medical devices or treatments, creating a conflict of interest between doing what is best for a patient versus what is in their best financial interest.[11] Conflict of interest in continuing medical education is also present, where physicians learn how to use certain medical devices during their board-certification courses that affect their patients.[12]

References

  1. ^ Malina, Debra; Rosenbaum, Lisa (2015). "Understanding Bias — The Case for Careful Study". New England Journal of Medicine. 372 (20): 1959–1963. doi:10.1056/NEJMms1502497. ISSN 0028-4793. PMID 25970055.
  2. ^ Friedberg, M; Saffran, B; Stinson, TJ; Nelson, W; Bennett, CL (20 October 1999). "Evaluation of conflict of interest in economic analyses of new drugs used in oncology". JAMA. 282 (15): 1453–7. doi:10.1001/jama.282.15.1453. PMID 10535436.
  3. ^ Blumenthal, D; Gluck, M; Louis, KS; Stoto, MA; Wise, D (13 June 1986). "University-industry research relationships in biotechnology: implications for the university". Science. 232 (4756): 1361–6. Bibcode:1986Sci...232.1361B. doi:10.1126/science.3715452. PMID 3715452.
  4. ^ Lundh, A; Lexchin, J; Mintzes, B; Schroll, JB; Bero, L (16 February 2017). "Industry sponsorship and research outcome". The Cochrane Database of Systematic Reviews. 2017 (2): MR000033. doi:10.1002/14651858.MR000033.pub3. PMC 8132492. PMID 28207928.
  5. ^ Rettig, RA (2000). "The industrialization of clinical research". Health Affairs. 19 (2): 129–46. doi:10.1377/hlthaff.19.2.129. PMID 10718027.
  6. ^ Wilkes, M. S.; International Committee of Medical Journal Editors (2001). "Sponsorship, Authorship, and Accountability". New England Journal of Medicine. 345 (11): 825–827. doi:10.1056/NEJMed010093. ISSN 0028-4793. PMC 1071574. PMID 11577056. {{cite journal}}: |author2= has generic name (help)
  7. ^ Palmer, N.; Braunack-Mayer, A.; Rogers, W.; Provis, C.; Cullity, G. (2006). "Conflicts of interest in divisions of general practice". Journal of Medical Ethics. 32 (12): 715–717. doi:10.1136/JME.2005.014811. PMC 2563353. PMID 17145912.
  8. ^ Wong, VSS; Avalos, LN; Callaham, ML (2019). "Industry payments to physician journal editors". PLOS ONE. 14 (2): e0211495. Bibcode:2019PLoSO..1411495W. doi:10.1371/journal.pone.0211495. PMC 6366761. PMID 30730904.
  9. ^ What These Medical Journals Don't Reveal: Top Doctors' Ties to Industry The New York Times, 2018
  10. ^ Wohl, Stanley. The Medical Industrial Complex / Stanley Wohl. First edition. New York: Harmony Book, 1984: 85-98
  11. ^ Xu, Amy L BS; Jain, Amit MD, FACS; Humbyrd, Casey Jo MD, MBE. Ethical Considerations Surrounding Surgeon Ownership of Ambulatory Surgery Centers. Journal of the American College of Surgeons: September 2022 - Volume 235 - Issue 3 - p 539-543 doi: 10.1097/XCS.0000000000000271
  12. ^ Relman, Arnold S. "Doctors as the Key to Health Care Reform." The New England journal of medicine. 361, no. 13 (2009): 1225–1227.

Further reading

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