Monday, June 25, 2007

Announcing the "Doctors for Dollars" Award

It's high time that doctors receive recognition for their efforts to partner with the pharmaceutical industry in creating educational programs. The Doctors for Dollars award will be given on a periodic basis to physicians, medical education companies, and pharmaceutical firms in recognition of outstanding achievement in masking promotional activities under the guise of continuing medical education.

Because the continuing medical education business is complex, each prize will be awarded to at least three lucky recipients. These include: 1) The pharmaceutical company funding the CME program with an "unrestricted educational grant;" 2) The medical education communication company (MECC) that takes the money to produce the activity; and 3) The physician (or group of physicians) who receives the money from the MECC in order to attach their name to the activity. Sometimes (as is true for today's award) there is a fourth recipient--the institution receiving money in order to award Category 1 credit to doctors who participate in the activity.

An apology to the disappointed: There are many, many deserving recipients of the Doctors for Dollars Award. If you are stakeholder in the industry-sponsored CME enterprise, and you are wondering why you haven't received an award, keep checking back to this website. There is a backlog of excellence, and I will be posting new honorees frequently!

The First 2007 Doctors for Dollars Award

Goes To...

Shire and Friends for
Most Convincing Bogus "Academic Councils"

Details of the Award

Winning Pharmaceutical Company:

Shire Pharmaceuticals

Winning Medical Education Communication Company:

Haymarket Medical

Winning Physician Group:

Massachusetts General Hospital Child Psychiatrists
(and some of their colleagues from other institutions)

Winning CME Provider:

Boston University School of Medicine, Continuing Medical Education Department


Shire Pharmaceuticals is currently THE name in ADHD medications, having propelled Adderall and Adderall XR into market leader status among psychostimulants. Now with two new versions of stimulants hitting the market (Daytrana methylphenidate patch, and Vyvanse, the "pro-drug" stimulant), Shire's marketing machinery is kicking it up another notch. They have been spreading cash thickly throughout the world of academic ADHD opinion leaders and have funded a series of CME newsletters produced by Haymarket Medical, with PRA Category 1 Credit being awarded by Boston University School of Medicine. Each newsletter come in a series of six monthly issues, and each is titled with a different academic-oid name, such as "New Perspectives on Adult ADHD," "Substance Use and ADHD," and "Adult ADHD and Common Comorbidities." Each newsletter lists a different "Academic Council" supposedly responsible for creating content.

Here is the cover of one of these not-very-newsy newsletters:

And here is the "Adult ADHD Academic Council" which legitimizes it:

There are several other similar councils. According to Jeff Forster, of Haymarket Medical, these "councils" have no institutional home, although council members are paid to attend a single meeting, during which they discuss what should go into the newsletters. They are also paid for "authorship" of CME articles, although presumably the articles are actually written by medical writers at Harmarket and signed, for a hefty fee, by the identified authors.

Such is the blistering pace of new knowledge in ADHD that Shire has funded dozens of these pseudo-newsletters over the past several months. Each newsletter flogs the knowledge-hungry physician with the same rotating series of pearls: 1) Adult ADHD is underdiagnosed; 2) Adult ADHD is a really bad disease, with lots of terrible consequences; 3) A lot of the patients that present with depression actually have ADHD if you dig deeply enough; 4) Stimulants don't lead to substance abuse, in fact they prevent future development of substance abuse; 5) Finally, and most importantly, psychostimulants are incredibly effective for Adult ADHD, so prescribe lots of them.

None of these statements are lies, but, like most statements in the world of ADHD, they are partial truths. Many would argue that adult ADHD is over-diagnosed, and that stimulants are over-prescribed in the United States. But this is a view that is censured in these ACCME accredited CME activities.

I suspect that the Shire Newsletter Blitz of 2007 will be viewed by historians as one of the more embarrassing collusions between psychiatric academia and the pharmaceutical industry.


Anonymous said...

Does the newsletter come with a free lunch carried in by an attractive rep? Where do I sigh up?

Anonymous said...

Nice one! :)

Gina Pera said...

" Many would argue that adult ADHD is over-diagnosed, and that stimulants are over-prescribed in the United States."

Sure, Dr. C, "many" would argue this. But that "many" don't know what they're talking about, so who cares? We've seen their nattering all over the Internet, and it's based on nothing but cultural mythology and ditto-heading.

ADHD is UNDER-diagnosed -- in children and adults.

Anonymous said...

I was diagnosed in 1966 with ADHD, long before it became the disorder voted most likely to be sneered at by professionals who I presume can read the research but most often don't bother.

What data are you basing this 'over-diagnosis' on? Because shire and pharmaceutical companies are scum bags? Correlation is not causation.

I expect big business to be scum bags what bothers me is the number of Psych docs who spout opinion about a disorder without looking at the actual research. A newsletter from shire is hardly reason to dismiss solid research.

I will second the previous poster and correct your opinion. ADHD is under diagnosed in both children and adults.

Ginnie Ollens

Anonymous said...

Interestingly I just now found the very newsletter pictured in this blog. As a facilitator of adult ADD groups I am always checking out new info, & am attempting to keep tabs on the meds. Is anyone else on this planet interested in dimension-driven treatment, foregoing diagnoses & disorders as labels, or am I the only one?
At least this newsletter has the balls to disclose their affiliations (which would make a sane person gag).
Thank you for this post confirming what I suspected & already knew. Whether ADD is under or over diagnosed is not the issue. What is the issue is assisting those who fit the descriptives.