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Corporate Science and the Husbandry of Scientific and Medical Knowledge by the Pharmaceutical Industry

Published online by Cambridge University Press:  01 December 2008

Alastair Matheson
Alastair Matheson
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E-mail: [email protected]
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Abstract

This article analyses the role of the pharmaceutical and medical device industries (‘pharma’) in the construction of scientific and medical knowledge. Pharma's activities are part of the broader dispositif of institutions, enterprises, regulations and constituencies within which medical-scientific knowledge is generated, but pharma's contributions exhibit a specific character reflecting commercial pressures. As drug development proceeds, research and marketing activities coalesce around ‘product canons’ that integrate scientific truth-claims and commercial positioning, generating knowledge with implicit commercial functionality. From this platform, pharma stamps consensus-building ‘narratives’ into medical-scientific discourse, in which ‘problems’ arise and are ‘solved’ by drugs. Concurrently, pharma modulates the structure of discourse and the social networks through which discourse proceeds. Implicit within these activities is a meta-science whose goal is to understand and technologize the operation of science to an external end. This mode of knowledge production can be viewed as a normative transformation of Kuhnian normal science, characterized by the attachment (and at times subordination) of paradigmatic tenets to extrinsic goals; exaggerated control of belief, research and consensus formation; and a capacity for infringement of traditional norms of scientific truthfulness. An International Standard of Integrity in Science would strengthen pharma's contributions to medical and scientific knowledge.

Keywords

FoucaultKuhnMarketingMedicinePharmaceutical IndustryScience Studies
Type
Articles
Information
BioSocieties , Volume 3 , Issue 4 , December 2008 , pp. 355 - 382
Copyright
Copyright © London School of Economics and Political Science 2008

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References

Angell, M. (2004). The truth about drug companies: How they deceive us and what to do about it. New York: Random House.Google Scholar
Applbaum, K. (2008). Where demand meets supply: Comorbidity and channel stabilization in the creation of a psychopharmaceutical blockbuster. Unpublished manuscript presented at the London School of Economics, 11 January.Google Scholar
Aronne, L. J. (2007). Therapeutic options for modifying cardiometabolic risk factors. American Journal of Medicine, 120 (3 Supplement 1), S26–34.Google Scholar
AstraZeneca (2008). AstraZeneca Cardiovascular division, URL (accessed May 2008): www.astrazenecacar diovascular.comGoogle Scholar
Barth, J., & Hahne, W. (2002). Review article: Rabeprazole-based therapy in Helicobacter pylori eradication. Alimentary Pharmacology & Therapeutics, 16 (Supplement 1), 31–33.CrossRefGoogle ScholarPubMed
Bekelman, J.E., Li, Y., & Gross, C.P. (2003). Scope and impact of financial conflicts of interest in biomedical research: A systematic review. Journal of the American Medical Association 289, 454–469.CrossRefGoogle ScholarPubMed
Bertrand, M.E., Simoons, M.L., Fox, K.A., Wallentin, L.C., Hamm, C.W., McFadden, E. et al. (2002). Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal, 23, 1809–1840.CrossRefGoogle ScholarPubMed
Beyond statin therapy: How to address the high short-term remaining risk in secondary prevention? (2006). Satellite symposium (Merck KGaA), World Congress of Cardiology, Barcelona, Spain, 2 September.Google Scholar
Brennan, T.A., Rothman, D.J., Blank, L., Blumenthal, D., Chimonas, S.C., Cohen, J.J. et al. (2006). Health industry practices that create conflicts of interest: A policy proposal for academic medical centers. Journal of the American Medical Association, 295, 429–433.CrossRefGoogle ScholarPubMed
Cain, D.M., Loewenstein, G., & Moore, D.A. (2005). The dirt on coming clean: Perverse effects of disclosing conflicts of interest. Journal of Legal Studies, 34, 1–25.CrossRefGoogle Scholar
Calabrese, J.R., Elhaj, O., Gajwani, P., & Gao, K. (2005). Clinical highlights in bipolar depression: Focus on atypical antipsychotics. Journal of Clinical Psychiatry, 66 (Supplement 5), 26–33.Google Scholar
Camm, A.J. (2001). Atrial fibrillation: Is there a role for low-molecular-weight heparin? Clinical Cardiology, 24 (3 Supplement), 15–19.CrossRefGoogle Scholar
Campbell, J. (2005). Understanding pharma: A primer on how pharmaceutical companies really work. Raleigh, NC: Pharmaceutical Institute.Google Scholar
Cannon, C.P., Braunwald, E., McCabe, C.H., Rader, D.J., Rouleau, J.L., Belder, R. et al. (2004). Intensive versus moderate lipid lowering with statins after acute coronary syndromes. New England Journal of Medicine, 350, 1495–1504.CrossRefGoogle ScholarPubMed
Cartwright, C., & Hollander, E. (1998). SSRIs in the treatment of obsessive-compulsive disorder. Depression and Anxiety, 8 (Supplement 1), 105–113.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Cho, M.K., & Bero, L.A. (1996). The quality of drug studies published in symposium proceedings. Annals of Internal Medicine, 124, 485–489.CrossRefGoogle ScholarPubMed
Coleman, D.L., Kazdin, A.E., Miller, L.A., Morrow, J.S., & Udelsman, R. (2006). Guidelines for interactions between clinical faculty and the pharmaceutical industry: One medical school's approach. Academic Medicine, 81, 154–160.Google Scholar
Comprehensive lipid management: Managing patients beyond LDL-C (2006). Satellite symposium (sponsored by MSD), World Congress of Cardiology, Barcelona, Spain, 5 September.Google Scholar
Del Prato, S., Bianchi, C., Miccoli, R., & Penno, G. (2007). Pharmacological intervention in prediabetes: Considering the risks and benefits. Diabetes, Obesity and Metabolism, 9 (Supplement 1), 17–22.CrossRefGoogle ScholarPubMed
Despres, J.P. (2006). Intra-abdominal obesity: An untreated risk factor for type 2 diabetes and cardiovascular disease. Journal of Endocrinological Investigation, 29 (3 Supplement), 77–82.Google Scholar
Di Norcia, V. (2003). The Olivieri Report—A compelling study of the growing tensions in clinical research. Science and Engineering Ethics, 9, 125–132.CrossRefGoogle ScholarPubMed
Dickersin, K. (2005). Publication bias: Recognizing the problem, understanding its origins and scope, and preventing harm. In Rothstein, H.R., Sutton, A.J., &Borentein, M. (Eds.), Publication bias in meta-analysis: Prevention, assessment and adjustments, 11–34. Chichester: John Wiley.Google Scholar
Dzau, V. (2005). The cardiovascular continuum and renin-angiotensin-aldosterone system blockade. Hypertension, 23 (Supplement 1), S9–S17.Google Scholar
Egger, M., Bartlett, C., & Juni, P. (2001). Are randomised controlled trials in the BMJ different? British Medical Journal, 323, 1253.CrossRefGoogle Scholar
Elliott, C. (2004). Pharma goes to the laundry: Public relations and the business of medical education. Hastings Center Report, 34, 18–23.CrossRefGoogle Scholar
Foucault, M. (1978). The history of sexuality, vol. 1: An introduction. New York: Random House.Google Scholar
Foucault, M. (1980). The confession of the flesh. In Foucault, M. (C. Gordon, Ed.), Power/knowledge: Selected interviews and other writings, 194–228. Brighton: Harvester Press.Google Scholar
Fuller, S. (2002). Thomas Kuhn: A philosophical history for our times. Chicago: U Chicago Press.Google Scholar
Futures (1999). Special Issue: Post-normal science. Futures, 31(7).Google Scholar
Giles, T.D. (2006). Circadian rhythm of blood pressure and the relation to cardiovascular events. Journal of Hypertension, 24 (2 Supplement), S11–S16.CrossRefGoogle ScholarPubMed
Gradman, A.H., & Traub, D. (2007). The efficacy of aliskiren, a direct renin inhibitor, in the treatment of hypertension. Reviews in Cardiovascular Medicine, 8 (Supplement 2), S22–S30.Google Scholar
Greene, J.A. (2007). Prescribing by numbers: Drugs and the definition of disease. Baltimore, MD: Johns Hopkins UP.Google Scholar
Hacking, I. (1999). The Social Construction of What? Cambridge: Harvard UP.Google Scholar
Halpern, S.D., & Berlin, J.A. (2005). Beyond conventional publication bias: Other determinants of data suppression. In Rothstein, H.R., Sutton, A.J., & Borenstein, M. (Eds.), Publication bias in meta-analysis: Prevention, assessment and adjustments, 303–318. Chichester: John Wiley.Google Scholar
Hayano, D.E. (1979). Auto-ethnography: Paradigms, problems and prospects. Human Organization, 38, 99–104.Google Scholar
Healy, D., & Cattell, D. (2003). Interface between authorship, industry and science in the domain of therapeutics. British Journal of Psychiatry, 183, 22–27.Google Scholar
Healy, D. (2004). Shaping the intimate: Influences on the experience of everyday nerves. Social Studies of Science, 34, 219–245.Google Scholar
Healy, D. (2006a). The latest mania: Selling bipolar disorder. PLoS Medicine, 3, e185.Google Scholar
Healy, D. (2006b). Manufacturing consensus. Culture, Medicine and Psychiatry, 30, 135–156.Google Scholar
Heres, S., Davis, J., Maino, K., Jetzinger, E., Kissling, W., & Leucht, S. (2006). Why olanzapine beats risperidone, risperidone beats quetiapine, and quetiapine beats olanzapine: An exploratory analysis of head-to-head comparison studies of second-generation antipsychotics. American Journal of Psychiatry, 163, 185–194.CrossRefGoogle ScholarPubMed
Hopewell, S., Clarke, M., Stewart, L., & Tierney, J. (2007). Time to publication for results of clinical trials. Cochrane Database of Systematic Reviews 18(2), MR000011.Google Scholar
Hopewell, S., Clarke, M., Moher, D., Wager, E., Middleton, P., Altman, D.G. et al. (2008). CONSORT for reporting randomised trials in journal and conference abstracts. Lancet, 371, 281–283.CrossRefGoogle ScholarPubMed
Hoyningen-Huene, P. (1993). Reconstructing scientific revolutions: Thomas S. Kuhn's philosophy of science. Chicago: U Chicago Press.Google Scholar
International Committee of Medical Journal Editors. (2006). Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication. URL (accessed September 2006): www.icmje.orgGoogle Scholar
International Working Group in Colorectal Cancer. (1997). An international, multidisciplinary approach to the management of advanced colorectal cancer. European Journal of Surgical Oncology, 23 (Supplement A), 1–66.Google Scholar
James, M.J., Cook-Johnson, R.J., & Cleland, L.G. (2007). Selective COX-2 inhibitors, eicosanoid synthesis and clinical outcomes: A case study of system failure. Lipids, 42, 779–785.Google Scholar
Jones, J. (2003). Sponsored publications. Pharmaceutical Marketing, August (Supplement: Practical Guide to Medical Publishing), 10–11.Google Scholar
Julius, S., Kjeldsen, S.E., Weber, M., Brunner, H.R., Ekman, S., Hansson, L. et al. (2004). Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: The VALUE randomised trial. Lancet, 363, 2022–2031.Google Scholar
Kondro, W., & Sibbald, B. (2004). Drug company experts advised staff to withhold data about SSRI use in children. Canadian Medical Association Journal, 170, 783.CrossRefGoogle ScholarPubMed
Kuhn, T.S. (1962). The structure of scientific revolutions. Chicago: U Chicago Press.Google Scholar
Kuhn, T.S. (1977). The essential tension: Tradition and innovation in scientific research? In Kuhn, T.S.The essential tension: Selected studies in scientific tradition and change, 225–239. Chicago: U Chicago Press.CrossRefGoogle Scholar
Lackey, R.T. (2004). Normative science. Fisheries, 29, 38–39.Google Scholar
Laine, C., Horton, R., DeAngelis, C.D., Drazen, J.M., Frizelle, F.A., Godlee, F. et al. (2007). Clinical trial registration: Looking back and moving ahead. Lancet, 369, 1909–1911.CrossRefGoogle ScholarPubMed
Lakoff, A. (2005). Pharmaceutical reason: Knowledge and value in global psychiatry. Cambridge: Cambridge UP.Google Scholar
Lexchin, J., Bero, L.A., Djulbegovic, B., & Clark, O. (2003). Pharmaceutical industry sponsorship and research outcome and quality. British Medical Journal, 326, 1167–1170.Google Scholar
Leys, D. (2001). Atherothrombosis: A major health burden. Cerebrovascular Disease, 11 (Supplement 2), 1–4.Google Scholar
LinkedIn.com (2008). Joseph Medel, Managing Consultant—BioStrategies Group. URL (accessed May 2008): www.linkedin.com/in/medeljjGoogle Scholar
Mancia, G. (2005). The association of hypertension and diabetes: Prevalence, cardiovascular risk and protection by blood pressure reduction. Acta Diabetologica, 42 (Supplement 1), S17–S25.Google Scholar
Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G. et al. (2007). 2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 25, 1105–87.Google Scholar
Matthews, A.W., & Martinez, B. (2004). Emails suggest Merck knew Vioxx's dangers at early stage. Wall Street Journal, 1 November: A1.Google Scholar
McGettigan, P., & Henry, D. (2006). Cardiovascular risk and inhibition of cyclooxygenase: A systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2. Journal of the American Medical Association, 296, 1633–1644.Google Scholar
McKenney, J.M. (2005). Pharmacologic options for aggressive low-density lipoprotein cholesterol lowering: Benefits versus risks. American Journal of Cardiology, 96(4A), 60E–66E.Google Scholar
McKenney, J.M. (Ed.) (2006). A symposium: Report of the National Lipid Association's Statin Safety Task Force. American Journal of Cardiology, 97 (Supplement 8A), 1C–97C.Google Scholar
MDProfile (2008). URL (accessed May 2008): www.emed-media.comGoogle Scholar
Metabolic Syndrome Institute. (Sponsored by an unrestricted educational grant from Solvay Pharmaceuticals and Abbott Laboratories). URL (accessed May 2008): www.metabolic-syndrome-institute.orgGoogle Scholar
Meurer, M., Lubbe, J., Kapp, A., & Schneider, D.(2007). The role of pimecrolimus cream 1% (Elidel) in managing adult atopic eczema. Dermatology, 215 (Supplement 1), 18–26.Google Scholar
Micardis (2008). URL (accessed May 2008): www.micardis.com/com/Home/About/index.jspGoogle Scholar
MicardisPlus (2008). Additional power including the early morning danger zone. Advertisement reproduced by HealthyScepticism.org, URL (accessed May 2008): www.healthyskepticism.org/adwatch/au/2004/micar dis.phpGoogle Scholar
Moore, R., Hernandez, D., & Valantine, H. (2001). Calcineurin inhibitors and post-transplant hyperlipidaemias.Drug Safety, 24, 755–756.Google Scholar
Olanow, C.W. (Ed.)(2004). Levodopa, COMT inhibition and continuous dopaminergic stimulation. Neurology, 62 (1 Supplement 1).Google Scholar
Oldani, M.J. (2004). Thick prescriptions: Toward an interpretation of pharmaceutical sales practices. Medical Anthropology Quarterly, 18, 325–356.Google Scholar
Petryna, A., Lakoff, A., & Kleinman, A. (Eds.) (2007). Global pharmaceuticals: Ethics, markets, practices. Durham, NC: Duke UP.Google Scholar
Pfizer 2008. Pfizer Neuroscience logo. URL (accessed May 2008): www.aocn.com.sg/images/Logo_Pfizer-Neuroscience-Lo.gifGoogle Scholar
Piepho, R.W. (2000). Overview of the angiotensin-converting-enzyme inhibitors. American Journal of Health-Syst Pharmacy, 57 (Supplement 1), S3–S7.Google Scholar
Popper, K. (1970). Normal science and its dangers. In Lakatos, I., & Musgrave, A. (Eds.) Criticism and the growth of knowledge, 51–58. Cambridge: Cambridge UP.Google Scholar
Poston, G.J., Adam, R., Alberts, S., Curley, S., Figueras, J., Haller, D. et al. (2005). OncoSurge: A strategy for improving resectability with curative intent in metastatic colorectal cancer. Journal of Clinical Oncology, 23, 7125–7134.CrossRefGoogle ScholarPubMed
Priori, S.G., & Zipes, D.P. (2006). Sudden cardiac death: A handbook for clinical practice. ESC Education Series. Oxford: Blackwell.Google Scholar
Rabinow, P., & Rose, N. (2006). Biopower today. BioSocieties, 1, 195–217Google Scholar
Reed-Danahay, D.E. (1997). Introduction. In Reed-Danahay, D.E. (Ed.), Auto/ethnography: Rewriting the self and the social, 1–17. Oxford: Berg.Google Scholar
Rennie, D. (2004). Trial registration: A great idea switches from ignored to irresistible. Journal of the American Medical Association, 292, 1359–1362.CrossRefGoogle ScholarPubMed
Ritz, E. (2006). Total cardiovascular risk management. American Journal of Cardiology, 100 (3 Supplement), S53–S60.Google Scholar
Rochon, P.A., Gurwitz, J.H., Simms, R.W., Fortin, P.R., Felson, D.T., Minaker, K.L. et al. (1994a). A study of manufacturer-supported trials of nonsteroidal anti-inflammatory drugs in the treatment of arthritis. Archives of Internal Medicine, 154, 157–163.CrossRefGoogle ScholarPubMed
Rochon, P.A., Gurwitz, J.H., Cheung, M., Hayes, J.A., & Chalmers, T.C. (1994b). Evaluating the quality of articles published in journal supplements compared with the quality of those published in the parent journal. Journal of the American Medical Association, 272, 108–113.Google Scholar
Safer, D. (2002). Design and reporting modifications in industry-sponsored comparative psychopharmacology trials. Journal of Nervous and Mental Disease, 190, 583–592.Google Scholar
Sanofi-Aventis (2006). Annual report. URL (accessed May 2008): http://en.sanofi-aventis.com/Images/sanofi_ra06_en_tcm24-17381.pdfGoogle Scholar
Scherbaum, W.A. (2005). Unlocking the opportunity of tight glycaemic control: Inhaled insulin: clinical efficacy. Diabetes, Obesity and Metabolism, 7 (Supplement 1), S9–S13.Google Scholar
Schilsky, R.L. (2002). End points in cancer clinical trials and the drug approval process. Clinical Cancer Research, 8, 935–938.Google ScholarPubMed
Schmieder, R.E. (2006). Endothelial dysfunction: How can one intervene at the beginning of the cardiovascular continuum? Journal of Hypertension,24 (2 Supplement), S31–S35.Google Scholar
Schneider, C.A. (2006). Improving macrovascular outcomes in type 2 diabetes: Outcome studies in cardiovascular risk and metabolic control. Current Medical Research and Opinion, 22 (Supplement 2), S15–S26.CrossRefGoogle ScholarPubMed
Sergeant, E., & Eden, A. (2003). Challenging publication planning. Pharmaceutical Marketing, August (Supplement: Practical Guide to Medical Publishing), 6–8.Google Scholar
Shapin, S. (1994). A social history of truth. Chicago: U Chicago Press.Google Scholar
Sismondo, S. (2007a). Ghost management: How much of the medical literature is shaped behind the scenes by the pharmaceutical industry? PLoS Medicine, 4, e286.Google Scholar
Sismondo, S. (2007b). Pharmaceutical company funding and its consequences: A qualitative systematic review. Contemporary Clinical Trials, 29(2), 109–113Google Scholar
Smith, M.C. (Ed.) (2008). Principles of pharmaceutical marketing. Philadelphia: Lee & Febiger.Google Scholar
Smith, R. (2005). Medical journals are an extension of the marketing arm of pharmaceutical companies. PLoS Medicine, 2, e138.Google Scholar
SPIRIT Bulletin (1993). Egham: Medical Action Communications.Google Scholar
Steiner, M., & Pearlstein, T. (2000). Premenstrual dysphoria and the serotonin system: Pathophysiology and treatment. Journal of Clinical Psychiatry, 61 (Supplement 12), 17–21.Google Scholar
Steinman, M.A., Bero, L.A., Chren, M.M., & Landefeld, C.S. (2006). Narrative review: The promotion of gabapentin: an analysis of internal industry documents. Annals of Internal Medicine, 145, 284–293.Google Scholar
Stimmel, G.L., & Gutierrez, M.A. (2006). Sexual dysfunction and psychotropic medications. CNS Spectrums, 11 (8 Supplement 9), 24–30.Google Scholar
Thor, K.B., Kirby, M., & Viktrup, L. (2007). Serotonin and noradrenaline involvement in urinary incontinence, depression and pain: Scientific basis for overlapping clinical efficacy from a single drug, duloxetine. International Journal of Clinical Practice, 61, 1349–1355.CrossRefGoogle ScholarPubMed
van Veldhuisen, D.J., & Poole-Wilson, P.A. (2001). The underreporting of results and possible mechanisms of ‘negative’ drug trials in patients with chronic heart failure. International Journal of Cardiology, 80, 19–27.Google Scholar
Williams, B. (2002). Truth and truthfulness: An essay in genealogy. Princeton, NJ: Princeton UP.Google Scholar
Yang, S. (2004). Novartis agreement became ‘lightning rod’ for debate. Berkleyan, 2 September. URL (accessed August 2007): www.berkeley.edu/news/berkeleyan/2004/09/02_novartis.shtmlGoogle Scholar
Ziman, J. (2003). Non-instrumental roles of science. Science and Engineering Ethics, 9, 17–27.Google Scholar