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Wednesday, March 12, 2008

Article Ties Together Pogo and Anechoic Effects

Ever wonder how the anechoic effect--why many, especially in the academy, sit idly by when questionable practices emerge from industry--fits in with the Pogo Effect ("we have met the enemy and he is us")?

In the article, "Allied Against Reform: Pharmaceutical Industry-Academic Physician Relations in the United States, 1945-1970," forthcoming in the Bulletin of the History of Medicine, but in March 2008 available (after registration) for download in preprint here , Dominique Tobbell of Penn and the Chemical Heritage Foundation supplies some of the connective tissue.

In this exceptionally well-researched article Tobbell argues convincingly that pharmaceutical reform in the 1960s was very much in the air--so much so that industry sought concertedly to create new alliances to blunt its impact. Capitalizing on concerns, not just within the AMA but also in the academy, about government oversight, industry representatives found new alliances in both places.

An expert advisory body, the Drug Research Board, to "guide government officials on pharmaceutical policy," was the result. "By positioning themselves as pharmaceutical experts, this alliance circumvented the FDA’s new authority," she argues, "[challenging] the efforts of pharmaceutical reformers to further increase the government’s role in drug development and practice."

Tobbell shows that the impulse to forge these alliances came, not just from industry, but also from the most rarefied reaches, such as Harvard, as early as the 1940s. When it became apparent that the government's influence on research was the Next Big Thing, individuals in both places, industry and medical schools, made common cause, she shows, to limit the authority of the FDA.

(Of course, the academy played on both sides. Funding is funding.)

Tobbell shows how it all came to a head in the more reformist 1960s and '70s, with issues swirling not just around research but around the then-emerging threats to directly-impacted revenue streams, such as proposals in favor of generic drug-substitution legislation.

Echo, anyone?

Well worth reading.

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