The New York Times
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November 30, 2008
Editorial

Expert or Shill?

More evidence has emerged of appalling conflicts of interest that throw into doubt the advice rendered and the research performed by two prominent psychiatrists who have received substantial funding from the pharmaceutical industry. The revelations prove, once again, the need for universities and professional societies to crack down on conflicts of interest, and for Congress to pass legislation that will bring hidden conflicts into the open.

Earlier this year, Congressional investigators discovered that Dr. Joseph Biederman, a world-renowned child psychiatrist at Harvard Medical School and Massachusetts General Hospital, had failed to report to Harvard at least $1.4 million in income from drug companies, in violation of the university’s conflict-of-interest guidelines.

Now, internal drug company e-mail and documents that surfaced in a lawsuit have sketched out what looks like an unsavory collaboration between Dr. Biederman and Johnson & Johnson to generate and disseminate data that would support use of an antipsychotic drug, Risperdal, in children, a controversial target group.

The various documents indicate that Dr. Biederman repeatedly asked a Johnson & Johnson subsidiary to fund a research center at Massachusetts General to focus on children and adolescents with bipolar disorders and that the company provided almost $1 million. Disturbingly, one of the center’s publicly stated missions, along with improving the psychiatric care of children, was to “move forward the commercial goals of J.& J.”

The company also drafted a scientific abstract on Risperdal for Dr. Biederman to sign — as if he were the author — before it was presented at a professional meeting. And it sought his advice on how to handle the uncomfortable fact, not mentioned in the abstract, that children given placebos, not just those given Risperdal, also improved significantly.

Dr. Biederman’s work and reputation have helped fuel a huge increase in the use of powerful, risky and expensive antipsychotic medicines in young people, an upsurge that brought a warning recently from a federally appointed panel of experts. Now it is hard to know whether he has been speaking as an independent expert or a paid shill for the drug industry.

Congressional investigators also recently reported that Frederick Goodwin, an influential psychiatrist who has been hosting a popular weekly program on public radio, earned at least $1.3 million by giving marketing lectures for drug makers who potentially stood to benefit from the recommendations he made on the program. He has rightly been removed from the air.