Report: Drug Trials Hiding Conflicts
Saturday, 15 May 1999
N E W  Y O R K  (AP)


HUNDREDS OF thousands of patients are being recruited by their personal
physicians into a booming venture for doctors - the business of testing
experimental drugs on people, The New York Times reports in its Sunday
editions.

The newspaper said a 10-month investigation revealed a system that is
fraught with conflicts of interest; that relies on government and
private monitoring that can be easily fooled and that some researchers
said is inadequate; and that secretly offers a share of the cash to
other health professionals who might influence patients to join a study.

The number of private doctors in research since 1990 has almost tripled,
and top recruiters can earn as much as $500,000 to $1 million a year,
according to the story, which was based on confidential documents and
interviews.

This new system is a boon for drug companies because it reaches out to a
vast pool of test subjects who have never before been available for
experimentation. But it also injects the interests of a giant industry
into the delicate doctor-patient relationship, usually without the
patient realizing it.

Among the specific findings of the Times' investigation:

-- Drug companies and their contractors offer large payments to doctors,
nurses and other medical staff to encourage them to recruit patients
quickly. And doctors do not even have to conduct trials to get paid:
There are finder's fees for those who refer their patients to other
doctors conducting research.

-- Doctors who recruit the most patients receive additional perquisites,
such as the right to claim a coveted authorship of published papers
about the studies -- even though the true author is a ghostwriter using
analysis from the drug company. Those who fail to meet the recruitment
goals are usually dropped from future studies.

-- Testing companies often use doctors as clinical investigators
regardless of their specialty, at times leaving patients in the care of
doctors who know little about their condition. For example,
psychiatrists have conducted Pap smears and asthma specialists have
dispensed experimental psychiatric drugs.

-- A growing number of doctors conducting drug research have limited
experience as clinical investigators, raising questions among some
experts about the quality of their data.