Who’s afraid of the big bad debate?

The American Society of Hypertension (ASH) has taken a lot of heat from those (including the journal Hypertension) who think it is too cozy with the pharmaceutical industry. Responding to the pressure, ASH scheduled a panel discussion on “Conflicts of Interest” for its upcoming conference. However, the society then canceled the session –calling it one-sided– and this was reported in the Boston Globe (Medical group puts stop to talks on drug-firm ties). Once news of the cancellation got out it caused more controversy; now ASH is reversing course again.

This time, according to the Globe (In shift, medical society to hold panel), ASH plans to invite advocates of pharmaceutical company involvement in addition to industry critics. That has the critics (including Harvard Medical School professor Jerry Avorn and former New England Journal of Medicine editors Marcia Angell and Jerome Kassirer) up in arms.

“It seems to be standing the whole thing on its head,” said Angell. She said the original intent of the panel had been to provide a counterweight to the drug industry’s sponsorship of scientific papers and physicians at the annual meeting.

“This seems like a very different panel than the one originally proposed,” Avorn said. “Those two individuals [the industry advocates] will be expressing views that are quite different from those that were originally envisioned.”

I don’t know why Angell and Avorn are complaining. Angell’s opposition, in particular, seems silly. Does it really make sense to balance one biased part of the conference with another biased part? I say get all sides in a room and argue it out in a lively debate. Certainly the drug companies deserve a chance to put forth their arguments. If the room is full of people with the same views no one will learn much.

It would also be useful to have some participants who aren’t physicians. A patient advocate or economist, for example. One reason physicians and pharmaceutical companies have become so intertwined is that physicians don’t understand economics very well.

January 8, 2007

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