A new study published in the BMJ found strong financial ties between the pharmaceutical industry and physicians serving as panelists and task force members of the DSM-5.
Pictured: A woman sits in the dark/iStock, simpson33
Around 60% of physicians who had served as panelists or task force members of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders received payments from industry, according to a study published Wednesday in The BMJ.
Together, these payments totaled $14.2 million and were made to 55 physicians with disclosures on the Open Payments database of the Centers for Medicare and Medicaid Services. Most of the payments were for food and beverage, reported by 91% of these doctors with ties to the industry, totaling $89,506.7.
Travel was also a major channel of compensation, with cumulative payments of $684,622.2 received by 69.1% of physicians. The BMJ analysis also found that industry paid nearly $1.18 million in consulting fees to more than two-thirds of the doctors.
Nineteen panel members also received a total of $1.83 million in “compensation for services other than consulting,” which could include being a speaker for the company.
“Our study was not designed (nor could it be) to determine if these financial ties affected decision making,” the study authors wrote. Nevertheless, industry influence and financial conflicts of interest “can lead to implicit bias, compromise the research process, and erode public trust.”
For instance, a 2017 study published in the journal Social Science & Medicine found that the pharmaceutical industry’s financial incentives could strongly influence the uptake of a new costly drug in the U.S. In states with bans or restrictions on gifts or honoraria, new and more expensive drugs were less likely to be prescribed than in states without such regulations, the authors wrote.
In the BMJ paper, the authors recommend that panelists and working group members who have the authority to make concrete changes, or exert significant influence over the DSM should be free of any ties to the industry as much as possible.
In an accompanying commentary, Lisa Cosgrove, clinical psychologist, professor and faculty fellow at the University of Massachusetts Boston, said that financial conflicts of interest have been a persistent problem for psychiatric medicine. She has worked on several studies in the past and observed that the ties between industry and doctors has not weakened.
She also noted that these conflicts of interest were concentrated in mental illnesses “where drugs are the first line of treatment.”
“A key step to creating trustworthy clinical guidelines is ensuring that they are developed by experts who are free of industry ties,” Cosgrove said. “In the case of the DSM, this recommendation is also important because panel members are able to eliminate disorders—not just add new ones—and thus could play a vital role in tackling overdiagnosis and overtreatment.”
Cosgrove is a senior author on the BMJ paper.
Tristan Manalac is an independent science writer based in Metro Manila, Philippines. He can be reached at tristan@tristanmanalac.com or tristan.manalac@biospace.com.
