Industry Influence in Dermatology Clinical Practice Guideline Development

Abstract

In his farewell address to the nation, in 1961, President Dwight D. Eisenhower warned about the rising influence of the military establishment and the arms industry. "The potential for the disastrous rise of misplaced power exists," the President said, referring to the military-industrial complex, "and will persist." 1 Forty years after that speech, as I began my dermatology residency, another complex with potential for misplaced power was ascending: the dermatology-industrial complex. Topical calcineurin inhibitors for atopic dermatitis and biologic drugs for psoriasis had just arrived, and marketing efforts werepardon the pun-on steroids.Industry was my partner, I was taught, as I learned to be a dermatologist. Indeed, I learned by reading textbooks and journals gifted to me by pharmaceutical companies and their representatives; attended lectures by drug company reps and industry-paid "thought leaders" at industry-sponsored events; provided patients with prescription and nonprescription drug samples from closets stocked by drug company reps, who also offered freebies for personal use ("You can have a lifetime supply," one would promise, referring to his company's moisturizers. "You just can't have it all at once!"); and went to the American Academy of Dermatology's (AAD) annual meeting-itself underwritten in large part by industry "partners"courtesy of pharmaceutical companies, which during the days distributed not only free samples but also companymonogrammed bags in which to carry them, and during the evenings hosted lavish parties, with free booze and, occasionally, a performance by a B-list celebrity (no offense, Pat Benatar; thanks for rocking out during the AAD meeting in New Orleans in 2002).In the years since I completed residency, the pendulum has in some ways swung in the other direction. I now decline free lunches, swag, party invitations, and other goodies offered by pharmaceutical companies. Many institutionsincluding Kaiser Permanente, where I work-have banned prescription drug samples and drug company-sponsored lunches. More broadly, the Institute of Medicine has recommended policies and procedures to mitigate conflicts of interest (COIs) arising from physician-industry interactions in medical research, education, and practice. 2 What about industry influence in dermatology clinical practice guidelines (CPGs)? Industry ties among CPG contributors have been reported, 3 and a study by Checketts et al 4 published in this issue of JAMA Dermatology seeks to address that

Editorial boards of dermatology journals and their potential financial conflict of interest

“…Twenty-two of those receiving industry payments inaccurately disclosed industry relationships, thus demonstrating a need for improved enforcement of clinical practice guidelines or revision of the standards [19]. An editorial raises questions regarding the significance of these finding Dermatology Online Journal || Commentary and calls for the AAD to increase transparency and perform its own audits regarding adherence to administrative regulations [20]. Leavitt et al evaluated the relationship between financial disclosure and study findings/validity in all clinical breast and cosmetic articles in Plastic and Reconstructive Surgery and Annals of Plastic Surgery published in 2013, and compared the findings to articles from Dermatology and Journal of Bone and Joint Surgery.…”

Evaluating Industry Payments Among Dermatology Clinical Practice Guideline Authors

“…To the Editor The article by Checketts et al regarding industry payments among dermatology clinical practice guideline (CPG) authors was accompanied by an editorial by Katz highlighting some of the problems with the study’s methodology. We have significant additional concerns regarding its conclusions.…”

Error in End Matter

“…In the Editorial titled “Industry Influence in Dermatology Clinical Practice Guideline Development” by Katz, the end matter has been corrected by adding “ Additional Information: Dr Katz is a member of the AAD and is co-chair of the AAD’s Expert Resource Group on LGBT/Sexual and Gender Minority Health, and a member of the AAD’s Bylaws Committee.”…”