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>Report: Drug Trials Hiding Conflicts

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>May 17, 1999 03:31 PM PDT

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> NEW YORK, May 17 (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.

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> 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.

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> 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.

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