Drug Companies and The AAP: The Real Truth
Submitted by Dr. Gwenn Is In
Last week’s American Academy of Pediatrics‘ (AAP) recommendation over Statin drug use in kids is still creating a firestorm. Over the weekend, Tara Parker-Pope at the NYT posted about her thoughts on why the AAP came up with such an extreme recommendation and wrote this:
“The new guidelines have raised questions about the pharmaceutical industry’s ties to both the A.A.P. and the members of the group’s nutrition committee that made the recommendations. But the A.A.P. asserted last week that “there is no involvement by any commercial entity in the development of any statement or report” it issues.
Reports filed with the Internal Revenue Service and provided by the A.A.P. show that the academy has received contributions from several companies with ties to statins, including $433,000 from Merck, $835,250 from Abbott Laboratories’ Ross Product Division and $216,000 from the Bristol-Myers Squibb company Mead Johnson Nutritionals. The biggest statin maker, Pfizer, is not listed as a contributor. The A.A.P. reported a total of $81 million in revenue in 2007.”
Let me address these criticisms and shed light to the facts of how the AAP interacts with pharmaceutical companies:
1. It is not unusual for pediatricians to consult to pharmaceutical companies. That is not big news. And, as she points out, pediatricians do disclose when they have financial ties to a company so that people are comfortable. I consulted the American Academy of Pediatrics about this issue, and here is what they sent me by email:
“All AAP committee members working on an AAP policy statement, clinical or technical report sign a conflict of interest disclosure form and voluntarily recuse themselves if a potential conflict exists. They are asked again at each meeting to disclose any conflicts related to the agenda.
Policy statements and clinical and technical reports are generally initiated by one or two authors and reviewed by the related committee(s), senior staff and AAP Board of Directors. This comprehensive review process can take up to a year to ensure accuracy and impartiality. Once approved by the Board of Directors, these documents represent the views of the AAP and not just those of the contributing authors.
There is no involvement by any commercial entity in the development of any statement or report emanating from the AAP.
2. Pharmaceutical companies do make contributions to the AAP at times but those are for educational purposes. And safeguards are in place to ensure appropriate use and no conflict of interest. For example, donations used to defray the cost of educational meetings are strictly regulated by the Accreditation Council for Graduate Medical Education.
3. As the AAP email to me makes crystal clear, there is never any influence between pharmaceutical money and outcome of AAP recommendations. To do so would be unethical and cause harm, which violates our oath as physicians “to do no harm”.
I can understand Ms. Parker-Pope’s objection to the use of Statin medications in children based on her personal principles. But, to accuse highly trained physicians who are this country’s top experts in their fields of any wrong-doing is going too far. That is akin to accusing the other team of cheating because you don’t like the outcome of a ball game.
So, disagree with the AAP, Ms. Pope. But, give credit to the the pediatric experts involved for trying to make recommendations that they feel are in the best interests of the future health of children. Like you and many of my pediatric colleagues, some of whom you’ve interviewed, I’m also not entirely sold on these recommendations but I have nothing but the highest regard for my colleagues who worked on these recommendations and came to the conclusions they made public last week. My clinical experience is what is driving me to respectfully be cautions of their conclusions but nothing more. I would ask you to show these highly regarded experts the same respect. The deserve at least that from all of us.
5:30pm Update:
Dr. Bryan at Parening Solved posted about this issue today as well. He makes some great points so be sure to check out his post.
Visit 1800blogger to see all of our industry leading blogs.
Have a health issue you want to discuss or just a general issue regarding children? Register on Children's Health Blog now and get published within minutes. Before posting, it is recommended that you review our posting guidelines.
