New feature about medical school and Big Pharma conflict of interest

I wrote this feature in Maclean’s about calls by doctors and medical students to have tighter conflict-of-interest policies on university of campuses, as schools increasingly look to industry for support.

As I was researching the piece, I came across this quotation from a 2004 New York Review of Books essay by the former editor-in-chief of the New England Journal of Medicine Marcia Angell:

The Reagan years and Bayh-Dole also transformed the ethos of medical schools and teaching hospitals. These nonprofit institutions started to see themselves as ‘partners’ of industry, and they became just as enthusiastic as any entrepreneur about the opportunities to parlay their discoveries in-to financial gain. Faculty researchers were encouraged to obtain patents on their work (which were assigned to their universities), and they shared in the royalties. Many medical schools and teaching hospitals set up ‘technology transfer’ offices to help in this activity and capitalize on faculty discoveries. As the entrepreneurial spirit grew during the 1990s, medical school faculty entered into other lucrative financial arrangements with drug companies, as did their parent institutions.

Angell points out how something we take for granted—pharma as a fixture on university campuses—is actually quite a new phenomenon, part of a very deliberate shift. She also speaks to the fact that medicine and pharma were not always tied together as they are now. This is new, too. We are only just learning about the impact of this relationship and how to manage it.

Though the debate about the pitfalls of pharmaceutical involvement in medical education has been waging for a while in the U.S., it seems to be enjoying a revival in Canada. During my Maclean’s research, I asked Tim Caulfield—an expert on the impact of research commercialization and many other things—about the transformation at Canadian schools, whether it was like the turn Angell describes south of the border. He said, “I don’t think there was the same ‘bright’ line. Rather, there has been a creep.” This creep was helped along by the enactment of this CIHR legislation in 2000 to promote commercialization and “economic development through health research.”

Slow creep or bright line, it’s a trend to pay attention to.

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