Harvard Psychiatrists Target 4-year old Children for Drug Trials

But a cadre of child psychiatrists at the nation's most prestigious medical centers, have made their career by working hand in glove with drug manufacturers on whose behalf they test the most toxic drugs in young children and lend their reputations to promote the use of these drugs--and drug combinations for young children--seemingly without regard for children's safety or welfare.

An example of crass commercialism can be seen in a MGH advertisement (2001) posted on YouTube (Mass Gen Bipolar Children Advert) that sought to recruit children as young as 4 to serve as human guinea pigs in one of its numerous lucrative psychotropic drug trials.

http://www.youtube.com/watch?v=RGkQdzU2DOk

The ad is an example of disease mongering and pathologizing childhood behavior. MGH department of psychiatry instills fear in parents by insinuating that their child's behavior problems are biological:

"Your child may be facing a chemical problem that you can't manage without help." "We're Mass General, and we can help." The number given to call is 617-724-4 MGH.

A report in the Boston Globe (2005) revealed that "After decades of offering continuing medical education classes in Boston, Harvard Medical School teaching hospital--Massachusetts General Hospital (MGH)--last year raised $6.5 million from Cephalon Inc., Janssen Medical Affairs, GlaxoSmithKline, and Wyeth for its 2005 program. The pool of money will allow the psychiatry department to dramatically expand its continuing medical education program with live lectures in 24 cities, teleconferences, and around-the-clock webcasts."

Dr. Robert Birnbaum, medical director of the Division of Postgraduate Education for the psychiatry department insults our intelligence when he claims : "The companies don't have any input into the curriculum, and there is no ongoing dialogue throughout the year."

As Dr. Arnold Relman, a Harvard Medical School professor, former editor of the New England Journal of Medicine, observed: "I am skeptical that a company would give a lot of money just to be able to say 'We were nice to the Mass. General Hospital.' "

Contact: Vera Hassner Sharav
212-595-8974

veracare@ahrp.org

The Boston Globe
PSYCHIATRY FUNDING QUESTIONED: DRUG FIRMS AID MASS. GENERAL
By Liz Kowalczyk
May 14, 2005

For the first time, Massachusetts General Hospital's renowned psychiatry department has accepted money from the pharmaceutical industry to educate doctors around the country .

After decades of offering continuing medical education classes in Boston, Harvard Medical School teaching hospital last year raised $6.5 million from Cephalon Inc., Janssen Medical Affairs, GlaxoSmithKline, and Wyeth for its 2005 program. The pool of money will allow the psychiatry department to dramatically expand its continuing medical education program with live lectures in 24 cities, teleconferences, and around-the-clock webcasts.

Mass. General psychiatrists said without outside funding they would have to charge doctors prohibitively high tuition. They said they have developed ways to minimize the risk that drug company money could bias classroom instruction.

"The companies don't have any input into the curriculum, and there is no ongoing dialogue throughout the year," said Dr. Robert Birnbaum, medical director of the Division of Postgraduate Education for the psychiatry department. "We're hoping this becomes a national model."

In recent years, the pharmaceutical industry has become increasingly interested in funding continuing medical education. While companies say their motive is to help educate doctors, the practice is raising concerns in the medical profession. Recently enacted rules have explicitly forbidden companies from nudging course content toward positive discussion of their drugs. But even those measures have not satisfied some critics.

"I am skeptical that a company would give a lot of money just to be able to say 'We were nice to the Mass. General Hospital,' " said Dr. Arnold Relman, a Harvard Medical School professor, former editor of the New England Journal of Medicine, and long-time critic of drug company involvement in education. "It's much more likely that despite the rules and regulations they hope they will influence the programs and improve their sales."

Most states require physicians to take 30 to 50 hours of instruction a year to keep current on treatments and to stay licensed. Hospitals, medical schools, and media and education companies nationwide offer thousands of different courses, from hour-long lectures to weekend seminars in exotic locations. Increasingly, the courses are paid for by drug firms, allowing doctors to attend for free or to pay minimal fees.

In 2003, drug companies for the first time accounted for more than half of the total funding of courses offered by organizations accredited by the Accreditation Council for Continuing Medical Education, which oversees continuing medical education for doctors. That year, the pharmaceutical industry gave those organizations $944 million for education. Total funding from all sources was $1.77 billion.

The potential influence of drug companies on doctors' education was highlighted by a federal investigation of Parke-Davis, now owned by Pfizer Inc. According to internal company documents released as part of the probe, the company developed a strategy for marketing its epilepsy drug, Neurontin, for unapproved uses. In a report titled "1998 Neurontin Tactics," a New York advertising firm suggested that the company sponsor classes on bipolar illness to increase awareness of Neurontin's effectiveness in treating the disorder. Last year, the company pled guilty to criminal conduct and agreed to pay a $430 million fine.

Federal regulators and medical community leaders have called for stricter standards, and last year the accreditation council adopted explicit rules to protect against drug company bias in continuing education . For example, it prohibits companies from selecting faculty for courses or from advertising their products during educational activities. But critics say that even with the new rules, drug companies still set the overall agenda by funding only courses that emphasize treatment with expensive brand-name drugs, rather than courses that don't focus on profitable products, such as behavioral therapy for depression.

Mass. General's psychiatry department, one of the nation's largest academic psychiatry departments, said it discourages that practice by asking firms to fund the entire curriculum for a year, rather than individual courses.

Many of the psychiatrists who teach the courses are consultants for, or receive research funding from, pharmaceutical companies, which they disclose to their audiences as required by the accreditation council.

Dr. Jerrold Rosenbaum, chief of psychiatry at Mass. General, said the department will not earn a profit from the expanded program. Ninety percent of the drug company money will be used to pay Primedia Healthcare, a Texas-based education and training company that produces brochures, arranges hotels and food during sessions and maintains the website. But psychiatrists who teach the classes will earn extra.

In the past, the department gave course instructors credits they could put toward professional dues or books. Now, they will get paid $2,000 to $4,000 per course. Birnbaum said that when he raises money for the program, he tells drug companies only about the general therapeutic focus of the courses, the instructors, and the types and number of activities planned. He said some companies do not request more specific information because they are eager to demonstrate that funding decisions are not based on the potential for drug sales.

Cephalon, a small pharmaceutical company based in Pennsylvania and the department's biggest funder, said it is developing products for anxiety and attention deficit hyperactivity disorder, so funding psychiatry courses fits into its overall strategy. "We fully expect to be marketing drugs in the psychiatric market, so it helps having our name out there, and aligning ourselves with Mass. General is a positive," said Sheryl Williams, a Cephalon spokeswoman.

Liz Kowalczyk can be reached at kowalczyk@globe.com.