First Word: Living in Glass Houses

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  C.P. Kaiser, Editor

You can hardly blink today without hearing the words “conflict of interest.” And with good reason: to preserve the integrity of science despite the source of research funding.

Several major medical institutions, such as Stanford University, announced this year that they will no longer accept support from pharmaceutical or device companies for specific programs in continuing medical education (CME). Pfizer overhauled its CME funding to reflect awareness of conflicts of interest and Eli Lilly will launch in 2009 an online registry that will detail its payments to physicians in the U.S.

The Medicare Payment Advisory Commission (MedPAC) is considering the establishment of a national database on physician and industry relationships. Earlier this year, Congress asked the American College of Cardiology to provide information about its new five-year partnership with the Cardiovascular Research Foundation (CRF). According to ACC officials, Congress is satisfied with the relationship.

In this issue of Cardiovascular Business, we have two articles that address the symbiotic relationship between industry and the medical community. Both in their own way acknowledge the potential problems and benefits of such relationships. The key is to be as upfront as possible in all dealings with industry.

In a commentary by Barry Katzen, MD, noted for founding the International Symposium on Endovascular Therapy (ISET), he astutely outlines the advantages of teaming up with industry. He also describes what it would look like if industry funding dried up. While it’s not the bleakest of portraits, one can see that he makes a good case for continuing to accept support from industry.

In the ACC Corner, college president Douglas Weaver, MD, also acknowledges the necessity of collaborating with industry, but Weaver details the deep level of transparency required by the ACC for members to serve on committees and for staff who deal with industry.

A strong message in both articles is that cardiology should police it’s own before unwanted restrictions are mandated from outside entities.

In the rest of the issue of Cardiovascular Business, you’ll find many articles that cite studies that were initially presented at conferences, which, for the most part, rely on industry support. It’s a circle of involvement that one cannot ignore. From laser heart therapy to echo contrast agents to oral anti-diabetic drugs, the cases to be made for or against a device or drug come to you inextricably entwined with industry—with much more transparency today than in past decades.