Protection of human subjects and the integrity of clinical trials are in jeopardy from the new economics of drug development, according to Marcia Angell, M.D., a lecturer on medical ethics at Harvard Medical School and a former editor of the New England Journal of Medicine. While editor of the journal, she issued an apology to readers for 19 instances in which the journal had published reviews of treatments even though the review authors had informed the editors of financial connections to drug companies. The editors admitted failing to apply journal policy, which prohibits review authors from having a financial interest in a company that makes a product discussed in the article.
As more scientists and institutions have financial stakes in research, she told faculty and students at a meeting of the Medical School Council in February, the drug approval system has become “riddled with financial conflicts of interest.” She suggests making drug company funding, clinical testing and ethical oversight independent of each other. “The result would be a system of checks and balances in which the influence of industry funding would be minimized,” she said.