CONFLICT-OF-INTEREST IN THE DEBATE OVER CALCIUM-CHANNEL ANTAGONISTS

Background Physicians' financial relationships with the pharmaceutical industry are controversial because such relationships may pose a conf lict of interest. It is unknown to what extent industry support of med ical education and research influences the opinions and behavior of cl inicians and researchers. The recent debate over the safety of calcium -channel antagonists provided an opportunity to examine the effect of financial conflicts of interest. Methods We searched the English-langu age medical literature published from March 1995 through September 199 6 for articles examining the controversy about the safety of calcium-c hannel antagonists. Articles were reviewed and classified as being sup portive, neutral, or critical with respect to the use of calcium-chann el antagonists. The authors of the articles were asked about their fin ancial relationships with bath manufacturers of calcium-channel antago nists and manufacturers of competing products (i.e., beta-blockers, an giotensin-converting-enzyme inhibitors, diuretics, and nitrates). We e xamined the authors' published positions on the safety of calcium-chan nel antagonists according to their financial relationships with pharma ceutical companies. Results Authors who supported the use of calcium-c hannel antagonists were significantly more likely than neutral or crit ical authors to have financial relationships with manufacturers of cal cium-channel antagonists (96 percent, vs. 60 percent and 37 percent, r espectively; P<0.001). Supportive authors were also more likely than n eutral or critical authors to have financial relationships with any ph armaceutical manufacturer, irrespective of the product (100 percent, v s. 67 percent and 43 percent, respectively; P<0.001). Conclusions Our results demonstrate a strong association between authors' published po sitions on the safety of calcium-channel antagonists and their financi al relationships with pharmaceutical manufacturers. The medical profes sion needs to develop a more effective policy on conflict of interest. We support complete disclosure of relationships with pharmaceutical m anufacturers for clinicians and researchers who write articles examini ng pharmaceutical products. (C) 1998, Massachusetts Medical Society.