Medical research often compromised by financial interests

• Merck, the pharmaceutical giant, is under siege.
• And one side effect of that siege is a public relations crisis for the Cleveland Clinic, a celebrated hospital and health care organization.
• It's the story of how growing conflicts of interest may be distorting both medical research and health care in general.
• Merck stands accused of playing down evidence that Vioxx, a best-selling painkiller until it was withdrawn last year, increases the risk of heart attacks.
• The most recent accusation of obscuring the evidence came from The New England Journal of Medicine, which discovered that the authors of a Merck-supported paper published in the journal had removed data unfavorable to Vioxx.
• Dr. Eric Topol, a famed cardiologist at the Cleveland Clinic, has been warning about the dangers of Vioxx since 2001.
• In videotaped testimony at a recent federal Vioxx trial (which ended in a mistrial), he accused Merck of scientific misconduct, and also testified that Merck's former chairman had called the chairman of the Cleveland Clinic to complain about his work --- an action Topol called "repulsive."
• A few days later, The Wall Street Journal reported on a web of financial connections between the Cleveland Clinic, its chief executive and AtriCure, a company selling a medical device used in a surgical procedure promoted by the clinic.
• Topol --- whose demotion also cost him his seat on the conflict-of-interest committee --- was "among those who questioned the ties," the newspaper said.
• The past quarter-century has seen the emergence of a vast medical-industrial complex, in which doctors, hospitals and research institutions have deep financial links with drug companies and equipment makers.
• The whole system of incentives encourages doctors and researchers to serve the interests of the medical industry.