Quite a battle has broken out over the decision of the NEJM not to
publish an editorial by Robert Steinbrook MD which is highly critical
of the ways in which Amgen’s Epoetin is prescribed in the U.S. There
are no agreed upon maximum levels for hemoglobin and it appears as if
Epo is being over prescribed at bigger than necessary doses by the
for-profit dialysis industry. Steinbrook’s editorial was published
in the Lancet. Questions also have arisen about why the Journal
chose to have Julie Ingelfinger write an editorial to substitute for
Steinbrook’s when she has close ties to the NKF–an organization that
receives a significant percentage of its funding from Amgen.
It is still very clear that the management of conflicts of interest
for universities, journals, academic health centers and even
bioethics centers remains conflicted with no consensus on mimimal
rules or about what constitutes a conflict. The academic and
journal communities would be well-served in the coming year to
convene a blue-ribbon panel to write a report on COI that might serve
as the starting point for addressing the complex questions involved.
– Arthur Caplan
Labels: Amgen, Conflict of Interest, Epoetin, New England Journal of Medicine