According the NPR health blog “Shots,” three psychiatrists at Harvard University who were leaders in research on bipolar disorder in children were punished over not disclosing payments from drug companies for research and other activities totaling more than $4.2 million dollars. (See “Harvard Punishes 3 Psychiatrists Over Undisclosed Industry Pay,” by Richard Knox.) The psychiatrists cannot accept any payments from industry for one year and must seek approval for any such payments after that period. Additionally they will suffer a “delay of consideration” for promotions and advancements in their institutions.
The doctors’ public response to this suggests that they felt that they operated in good faith and that they now realize they should have paid more attention to the details regarding disclosure.
These researchers, Joseph Biederman, Timothy Wilens, and Thomas Spencer were leaders in identifying a new way of understanding bipolar disorder in children, which subsequently led to massive increases in the frequency of that diagnosis and in the rates of using powerful medications to treat the disorder. They received large sums of money from the company that makes Abilify – and the use of this drug skyrocketed in the context of this research.
I have written previously on this topic (see “Childhood Bipolar: Who’s Funding That Study?“) and I find it mind boggling that such a gross conflict of interest could be considered a minor problem in reporting “details” to the government and the prestigious institutions that these doctors work for. At many levels we doctors continue to convince ourselves that the pharmaceutical industry perks and marketing – from the pens they leave in the office to the millions of dollars they pay us for research – don’t influence our prescribing habits. But this is clearly wrong – the marketing and payments work extremely well. We are, after all, still humans, and no less vulnerable to marketing and influence than other people. We have to be honest with ourselves before we can be rid of this terrible influence of industry on our practices.
While there are truly children with bipolar disorder, the research that has come since the original articles has clearly indicated that the rates of the disorder are not as high as has been suggested and that use of such strong medications should be much more carefully considered before being used in children. Big pharma has played a huge role in this fiasco, children and families have paid the price, while the doctors such as these Harvard psychiatrists, have earned the big bucks, walking away with only a slap on the wrist.
Photo by Stephen Depolo, available under a Creative Commons attribution license.