New research suggests that multiple sclerosis (MS) patients are interested in knowing the details of their physicians’ financial relationships with pharmaceutical companies, and that patients’ participation in clinical trials for new MS therapies may be influenced by such disclosures. The revelation of these potential conflicts of interest to clinical trial participants is not always included as part of informed consent and documentation practices, suggesting a need for uniform guidelines on physician-industry relationships.
Almost half a million Americans live with MS, most of whom depend on disease-modifying drugs to control symptoms. Patients diagnosed with the disabling disease of the central nervous system may experience balance issues, vision problems and weakness. Industry-sponsored clinical trials (ISCT) have led to the development of new treatments for MS, with the involvement of academic and private practice physicians who provide care for MS patients. The authors of the study were interested in how much, if anything, patients want to know about their doctors’ financial relationships with the pharmaceutical industry firms that conduct such trials.
A team of researchers led by Andrew Solomon, MD, an assistant professor in the Department of Neurological Sciences at the University of Vermont College of Medicine, developed an anonymous online survey to investigate patient attitudes on the issue of physician conflicts of interest. The survey was conducted among 597 MS patients in the United States. A total of 552 participants completed the entire survey, with responses representing patients who had participated in ISCTs as well as those who were not part of any clinical trials sponsored by the pharmaceutical industry.
“Physician-industry collaborations have advanced important scientific knowledge and helped develop new therapies that have significantly improved the lives of patients with MS,” Dr. Solomon said. “However, direct industry financial support of physicians, physician practices, and academic departments involved in MS therapy-related multicentre ISCTs are an infrequently acknowledged source of potential physician conflict of interest, so we wanted to gauge patients’ perspective on the issue.”
A majority of surveyed patients said they believed that it was important to disclose physician-pharma relationships, including revenue generated for speaking engagements or consulting activities. They specified clinical trial “compensation toward principal investigator salary” as the most important type of financial relationship between physicians and drug companies.
“While our study demonstrates the importance of disclosure of information concerning physician conflicts of interest in MS ISCTs to potential participants, our findings – drawn from a single survey – are limited. More research on patient perspectives on this important issue, as well as how to most effectively incorporate this information into the consent process for research studies, is needed,” Solomon said.
The study’s findings appear online in Multiple Sclerosis Journal.
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