1. Facci un'articolo.
2. Potremmo anche aggiungere che uno dei motivi per cui le
compagnie farmaceutiche americane hanno appoggiato Bush nelle
campagne elettorali 2000 e 2004 e' che l'amministrazione Bush nel
periodo 2000-2004 ha garantito per legge che spetta alle
compagnie fissare il prezzo dei medicinali che vengono messi a
disposizione dei servizi sanitari nazionali.

bax.s.


On 4 Nov 04, at 16:09, mauro wrote:

Il direttore degli NIH americani ha emanato una moratoria sulle
consulenze pagate a biotech e pharma.
questo l'articolo originale.

NIH in the spotlight over conflicts of interest

On September 23, National Institutes of Health (NIH) Director, Elias
Zerhouni, announced a 1 year moratorium on any NIH employee
participating in paid consultancy work for the biotech or pharmaceutical
industry. This is the latest move by Zerhouni to counter escalating
concern that NIH researchers are supplementing their income with
consultancy payments from drug companies. Investigations were sparked by
a news story reported in the /Los Angeles Times/ in December last year,
which alleged that researchers at several NIH institutes had received
consultancy payments from outside sources that could inappropriately
influence their research.

The /Los Angeles Times/ story opens by recounting an incident 5 years
ago when a participant in a clinical trial of a treatment for kidney
inflammation died from an adverse reaction. According to the news story,
the director of the NIH institute at which the study was being done was
a paid consultant for the company that manufactured the drug. The news
story goes on to reveal alleged financial conflicts for several senior
researchers at various NIH institutes. Many people have questioned
how—in the light of such huge potential conflicts of interest—the
American public can maintain their faith in the integrity of clinical
research at NIH.

Zerhouni's immediate response to the article was to set up a Blue Ribbon
committee to review NIH's policies on conflicts of interest and to
provide recommendations for their revision. The panel's report,
published in May, lists 18 recommendations
(http://www.nih.gov/about/ethics_COI_panelreport.pdf ). Among these, the
panel recommended that all senior management and extramural employees
should not engage in any paid consultancy activities and intramural
scientists involved in research on human beings should not have any
financial involvement with companies whose interests could be affected
by their research.

In June, the House Energy and Commerce Committee's oversight and
investigations subcommittee presented the findings from their own
investigation: after asking 20 drug companies to provide records of
payments to NIH researchers, about 100 agreements were brought to light
that did not appear on NIH's records. One example is a researcher at the
National Institute of Mental Health who is thought to have received over
half a million dollars in consultancy fees, honoraria, and expenses from
Pfizer since 1998. In light of these findings, Zerhouni—who had
previously defended the consultancy activities of NIH staff—announced a
ban on senior researchers participating in paid consultancy activities,
a ban that has now been extended to all staff.

The deficiencies in NIH's current conflicts of interest policy stem from
the reign of Harold Varmus, Zerhouni's predecessor. In 1995, Varmus
changed NIH's policies such that there was no limit on the amount of
money employees could earn from outside activities and removed the ban
on senior staff doing paid consultancy work.

Some scientists welcome Zerhouni's moratorium and a return to the
pre-1995 policies, hoping that NIH will now develop a clearer policy
that leaves employees in no doubt of the rules. Others fear that if the
moratorium becomes more than a temporary measure, such extensive
restrictions on the interaction between academic and commercial research
will choke important scientific advances. In addition, NIH may find it
harder to attract top scientists if they cannot supplement their income
with consultancy fees.

One feature of financial conflicts that is often overlooked is the
potentially limitless source of revenue from patent royalties. Indeed,
Zerhouni's Blue Ribbon panel recommends that “there should be no
restriction on royalties… or income received from patents”. It is /The
Lancet Neurology/'s policy, and that of other journals, not to
commission reviews or commentaries from authors who hold or are applying
for patents related to the subject of their article. The reasoning
behind this policy is that, like other finanical conflicts, an author
objectivity may be blurred by the ownership of intellectual property.

Is this policy fair to the academic researcher who is merely
safeguarding their discoveries? Let's look at it from the standpoint of
a patient in a clinical trial. Would you be any more comfortable knowing
that the study investigator had a patent on use of the trial drug for
treatment of your disease than if that investigator had been a paid
consultant for the trial sponsor?

A new study—the Conflicts of Interest Notification Study—has recently
begun at Johns Hopkins University to help establish policy and practice
on how to disclose potential conflicts of interest to participants in
clinical trials. Although conflicts of interest are a major worry for
Zerhouni and NIH, and a regular headache for journal editors, the most
important consideration is to ensure the safety of patients in clinical
trials.

/The Lancet Neurology/


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