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Swine flu pandemic health experts with pharma links more likely to talk up risks and promote drugs

Competing interests should be declared - and reported - to maintain credibility of public health, say researchers.

Academics with links to the pharmaceutical industry were six times more likely to talk up the risks of the 2009-10 swine flu pandemic in the media and eight times more likely to promote the use of antiviral drugs than those experts without ties to pharma, according to new research published in the Journal of Epidemiology and Community Health.

During the 2009-2010 swine flu pandemic, the UK spent an estimated £1 billion on pharmaceuticals, including antiviral drugs (neuraminidase inhibitors) and an H1N1 specific vaccine. Pharma made £4.5-6.5 billion out of H1N1 vaccines alone. Concerns were subsequently raised about the links (competing interests) experts on influential scientific advisory committees, including the WHO’s Emergency Committee, had with drug companies.

Researchers led by the London School of Hygiene & Tropical Medicine retrospectively analysed 425 articles about the HIN1 swine flu pandemic in UK daily, Sunday, tabloid, middle market, and broadsheet newspapers, to assess the extent of competing interests among sources quoted between April and July 2009 – the period when major decisions were being made about how best to respond to the emerging threat.

The analysis showed that during the study period, health ministers were the most frequently quoted source (34%) in media articles on swine flu, followed by academics (30%). Sixty one academics were quoted, 18 (30%) of whom had competing interests.

The academics made 74 risk assessments, over half of which (44; 59.5%) were higher than those made by official agencies (e.g. the Department of Health) in the same article.

Of these, 35 were made by academics with competing interests, meaning that risk assessments from academics with competing interests were almost six times as likely to be higher than official agencies than those made by academics without any industry links.

Twenty academics commented specifically on drugs/vaccines in 36 articles (8.5% of the total). Half of them had competing interests— a higher proportion than the one in three on the WHO’s Emergency Committee. Half of the commentators promoted the use of antiviral drugs and around half (45%) promoted the use of a vaccine. Some 15% promoted both.

Academics promoting the use of antiviral drugs in newspaper articles were eight times more likely to have pharma industry links than those not commenting on their use. Only three articles out of the 425 mentioned that the quoted academic had a potential competing interest. Grants, honoraria, speakers’ fees, consultancies, advisory roles, employment, and directorship/stock ownership were all considered competing interests.

Lead author Kate Mandeville, Clinical Research Fellow at the School, said: "Our study provides some evidence that higher risk assessments and the promotion of antiviral drugs were associated with competing interests among public health academics. These add to the growing body of literature highlighting the potential influence of the pharmaceutical industry on major policy decisions through avenues such as scientific advisory committees, guidelines, and media commentary.

"Competing interests that aren't disclosed harm the public's perception of the independent voice of public health academics. Academics should declare, and journalists ask for and report, competing interests for media interviews."

The researchers acknowledge that the original interviews may have contained more nuanced views than appeared in print, and that journalists may have sought divergent views to balance a story or increase its newsworthiness.

Publication

  • K L Mandeville, S O'Neill, A Brighouse, A Walker, K Yarrow, K Chan. Academics and competing interests in H1N1 influenza media reporting. Journal of Epidemiology and Community Health. DOI: 10.1136/jech-2013-203128
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