Re: A Systematic Review and Meta-Analysis of Statin Therapy in Children With Familial Hypercholesterolemia

Here's more on Dr. Biederman and friends from the Carlat Psychiatry
blog:

Monday, June 25, 2007
Announcing the "Doctors for Dollars" Award

It's high time that doctors receive recognition for their efforts to
partner with the pharmaceutical industry in creating educational
programs. The Doctors for Dollars award will be given on a periodic
basis to physicians, medical education companies, and pharmaceutical
firms in recognition of outstanding achievement in masking promotional
activities under the guise of continuing medical education.

Because the continuing medical education business is complex, each
prize will be awarded to at least three lucky recipients. These
include: 1) The pharmaceutical company funding the CME program with an
"unrestricted educational grant;" 2) The medical education
communication company (MECC) that takes the money to produce the
activity; and 3) The physician (or group of physicians) who receives
the money from the MECC in order to attach their name to the activity.
Sometimes (as is true for today's award) there is a fourth recipient--
the institution receiving money in order to award Category 1 credit to
doctors who participate in the activity.

An apology to the disappointed: There are many, many deserving
recipients of the Doctors for Dollars Award. If you are stakeholder in
the industry-sponsored CME enterprise, and you are wondering why you
haven't received an award, keep checking back to this website. There
is a backlog of excellence, and I will be posting new honorees
frequently!

The First 2007 Doctors for Dollars Award

Goes To...

Shire and Friends for
Most Convincing Bogus "Academic Councils"

Details of the Award

Winning Pharmaceutical Company:

Shire Pharmaceuticals

Winning Medical Education Communication Company:

Haymarket Medical

Winning Physician Group:

Massachusetts General Hospital Child Psychiatrists
(and some of their colleagues from other institutions)

Winning CME Provider:

Boston University School of Medicine, Continuing Medical Education
Department

Background:

Shire Pharmaceuticals is currently THE name in ADHD medications,
having propelled Adderall and Adderall XR into market leader status
among psychostimulants. Now with two new versions of stimulants
hitting the market (Daytrana methylphenidate patch, and Vyvanse, the
"pro-drug" stimulant), Shire's marketing machinery is kicking it up
another notch. They have been spreading cash thickly throughout the
world of academic ADHD opinion leaders and have funded a series of CME
newsletters produced by Haymarket Medical, with PRA Category 1 Credit
being awarded by Boston University School of Medicine. Each newsletter
come in a series of six monthly issues, and each is titled with a
different academic-oid name, such as "New Perspectives on Adult ADHD,"
"Substance Use and ADHD," and "Adult ADHD and Common Comorbidities."
Each newsletter lists a different "Academic Council" supposedly
responsible for creating content.

Here is the cover of one of these not-very-newsy newsletters: [does
not reproduce]

And here is the "Adult ADHD Academic Council" which legitimizes it:
[Dr. Biederman and others]

There are several other similar councils. According to Jeff Forster,
of Haymarket Medical, these "councils" have no institutional home,
although council members are paid to attend a single meeting, during
which they discuss what should go into the newsletters. They are also
paid for "authorship" of CME articles, although presumably the
articles are actually written by medical writers at Harmarket and
signed, for a hefty fee, by the identified authors.

Such is the blistering pace of new knowledge in ADHD that Shire has
funded dozens of these pseudo-newsletters over the past several
months. Each newsletter flogs the knowledge-hungry physician with the
same rotating series of pearls: 1) Adult ADHD is underdiagnosed; 2)
Adult ADHD is a really bad disease, with lots of terrible
consequences; 3) A lot of the patients that present with depression
actually have ADHD if you dig deeply enough; 4) Stimulants don't lead
to substance abuse, in fact they prevent future development of
substance abuse; 5) Finally, and most importantly, psychostimulants
are incredibly effective for Adult ADHD, so prescribe lots of them.

None of these statements are lies, but, like most statements in the
world of ADHD, they are partial truths. Many would argue that adult
ADHD is over-diagnosed, and that stimulants are over-prescribed in the
United States. But this is a view that is censured in these ACCME
accredited CME activities.

I suspect that the Shire Newsletter Blitz of 2007 will be viewed by
historians as one of the more embarrassing collusions between
psychiatric academia and the pharmaceutical industry.

Posted by Daniel Carlat, M.D. at 6:30 AM




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