COURAGE Guinea pigs — patients at veterans hospitals

Optimal Medical Therapy with or without PCI for Stable Coronary Disease, NEJM April 12, 2007
Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation
(COURAGE)

This is not to question the ethical standards of the men and women who conducted this research, nor is it to voice a cultural criticism regarding the Veterans Administration as a source of clinical subjects for evaluation. Rather, it’s presented as an eye-opener. Lecture fees, consulting fees, and grant support from the pharmaceutical industry seem to power the engine of clinical research, while cross ventilation of ideas from the clinical researchers to their industry counterparts seems to be the quid pro quo.

“Dr. Boden reports receiving consulting fees and lecture fees from Kos Pharmaceuticals, PDL BioPharma, Pfizer, CV Therapeutics, and Sanofi-Aventis, and grant support from Merck and Abbott Laboratories; Dr. O’Rourke, consulting fees from King Pharmaceuticals, Lilly, and CV Therapeutics; Dr. Teo, grant support from Boehringer Ingelheim; Dr. Knudtson, lecture fees from Medtronic and Lilly; Dr. Harris, having equity ownership in Amgen; Dr. Chaitman, receiving consulting fees from CV Therapeutics, Merck, and Bayer, lecture fees from Pfizer, AstraZeneca, and CV Therapeutics, and grant support from Pfizer, CV Therapeutics, and Sanofi-Aventis; Dr. Shaw, grant support from Bristol-Myers Squibb and Astellas Healthcare; Dr. Booth, grant support from Actelion; Dr. Bates, consulting fees from Sanofi-Aventis and AstraZeneca and lecture fees from Sanofi-Aventis; Dr. Spertus, consulting fees from Amgen and United Healthcare and grant support from Amgen, Roche Diagnostics, and Lilly (and in the past, consulting fees and grant support from CV Therapeutics and owning the copyright for the Seattle Angina Questionnaire, the Peripheral Artery Questionnaire, and the Kansas City Cardiomyopathy Questionnaire); Dr. Berman, consulting fees and lecture fees from Bristol-Myers Squibb, Astellas, Tyco, and Siemens and grant support from Bristol-Myers Squibb and Astellas; Dr. Mancini, consulting and lecture fees from Pfizer, Abbott, and GlaxoSmithKline, lecture fees from Merck and Sanofi-Aventis, and grant support from Cordis and GlaxoSmithKline; and Dr. Weintraub, consulting fees from Sanofi-Aventis and Bristol-Myers Squibb and grant support from Sanofi-Aventis. No other potential conflict of interest relevant to this article was reported.”

Posted in Medical Advice, Science
6 comments on “COURAGE Guinea pigs — patients at veterans hospitals
  1. leslie says:

    This is not to question the ethical standards of the men and women who conducted this research –

    i’ve been following similar issues concerning hepatitis c research specifically. chiron is a pharmaceutical co. that owns over 100 patents on the hcv genome (!) and are able to regulate all research on hcv. and i have to say: i seriously question their ethical standards. smaller researchers are severely restricted in the types of research they can do on this virus because of all the red tape and big bucks it takes just to get permission from chiron to use “their” property i.e. the virus itself. (!)

    here‘s an article from 2004 that was in the times – describing relations between doctors and pharmaceutical companies.

    -are you baiting me? 🙂 childbirth as a medical emergency and state mandated drugging of children with anti-depressants next?

  2. Really, the “intellectual property” practices that have formed like dental plaque around the toothsomely profitable field of genomics are absurd. The idea that a company can patent a gene needs to be challenged by somebody. Imagine if scientists had been able to patent each “new” species of plant or animal revealed to the Europeans during the age of discovery. (Pity the guy who held patents on the dodo and/or the passenger pigeon — no profits there!)

    Seriously, sorting the sheep from the goats in big-pharma/physician pay-outs is the least of our problems as we try to corral those corporations.

    One area that needs attention is “orphan drugs.” The size of the market and the corporation’s ability to carve out market share should have nothing to do with research or treatment.

    Pass the Ritalin, please.

  3. JH says:

    Is there any medical research in the USA funded by government agencies, or is it all “funded” via the private sector ?

    Honest question, to which I do not know the answer …

  4. fp says:

    Years ago I know that here were huge federal contracts and grants at the universities, so a lot of the basic science that was done at university medical schools was funded in whole or in part by the government. I don’t know how the income side of the budget looks today for postdoc projects. I think there are dribs and drabs of government money available for research on orphan drugs and such, but if there’s a profit to be made then big business will be involved.

  5. madame l. says:

    your comment prompted me to look up “passenger pigeon” i had no idea–>
    One method of killing was to blind a single bird by sewing its eyes shut using a needle and thread. This bird’s feet would be attached to a circular stool at the end of a stick that could be raised five or six feet in the air, then dropped back to the ground. As the bird attempted to land, it would flutter its wings, thus attracting the attention of other birds flying overhead. When the flock landed near this decoy bird, nets would trap the birds and the hunters would crush their heads between their thumb and forefinger. This has been claimed as the origin of the term stool pigeon,[12] though this etymology is disputed.[13]

  6. fp says:

    Red in tooth and claw… man the vicious animal

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