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Psychiatric drugs fare favorably when companies pay for studies

USA Today
By Marilyn Elias

Drug companies fund a growing number of the studies in leading psychiatric journals, and drugs fare much better in these company-funded studies than in trials done independently or by competitors, researchers reported Wednesday. About 57% of published studies were paid for by drug companies in 2002, compared with 25% in 1992, says psychiatrist Igor Galynker of Beth Israel Medical Center in New York City.

His team looked at clinical research in four influential journals: American Journal of Psychiatry, Archives of General Psychiatry, Journal of Clinical Psychiatry and Journal of Clinical Psychopharmacology.

In the report, released at the American Psychiatric Association meeting in Toronto, reviewers did not know who paid for the studies they evaluated, Galynker says. There were favorable outcomes for a medication in about:

. Eight out of 10 studies paid for by the company that makes the drug.

. Five out of 10 studies done with no industry support.

. Three out of 10 studies done by competitors of the firm making the drug.

The findings don't prove the companies are knowingly biasing studies, says co-author Robert Kelly Jr., also with Beth Israel. The report didn't look at the evidence for bias in design of the studies.

As drug companies increasingly fund research that yields favorable outcomes for their drugs, there may be a built-in bias because journals are reluctant to publish studies with negative or inconclusive findings, Galynker says.

In October 2004, the pharmaceutical industry set up a database to allow publication of all studies, positive and negative, says Alan Goldhammer of the Pharmaceutical Research and Manufacturers of America, trade group for the drug companies. "We want to improve transparency," he says.

Because drug studies are very expensive, pharmaceutical companies fund those most likely to have a positive outcome, Goldhammer says. The firms weed out drugs that don't work and consult with the Food and Drug Administration to design trials that will pass muster with the FDA. "We're constantly trying to develop new drugs to treat mental illness," he says.

Posting a negative study on the database is voluntary. "And common sense dictates that the worse the drug does, the less likely you are to volunteer to beat yourself up publicly by sharing that," says Sidney Wolfe of Public Citizen, the Washington-based consumer advocacy group.

"We're seeing a huge tilting in the education of psychiatrists toward the industry point of view on psychiatric drugs," Wolfe says. "And that point of view is, 'Prescribe my drug, it's better.'"

The government should be funding more of this research because public programs, such as Medicare, pay so much for psychiatric drugs, Wolfe says.