Psychiatrists Will Need to Clean Up Their Act According to Healthcare Reform

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Psychiatrist Dr. Thomas Insel is quite excited that the new healthcare reform will require that psychiatrists clean up their act and will have to disclose their dealings with pharmaceutical companies. In fact he stops short of calling researchers corrupt or asking them to stop taking money from drug companies. He is unhappy with the "bias in prescribing practices" that favors brand names drugs over cheaper generics and non-drug treatments. And he says the situation must change with new standards for transparency and full disclosure of psychiatry's collaborations with industry.

"We can show the rest of medicine how to clean up our act," Insel said. His commentary appears in Wednesday's Journal of the American Medical Association.

"Transparency is the first step toward giving patients and the public the tools they need to evaluate those relationships," said Allan Coukell, director of the Pew Prescription Project, a consumer health project of the nonprofit Pew Charitable Trusts.

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In 2008, an inquiry by Sen. Chuck Grassley, uncovered millions of dollars in unreported fees paid by drug industry to prominent researchers. Because of this inquiry, seven psychiatrists were accused of failing to report payments they received from drug companies, Insel said he tried to determine whether psychiatrists were being targeted unfairly.

What he found instead was evidence that psychiatry may have more drug ties than other medical specialties. In Vermont, for example, which requires public disclosure of industry payments to doctors, psychiatrists receive more money from drug companies than do other types of doctors.

In fact, psychiatric journals report slightly higher rates of industry funding of published studies than other medical journals. And one study found that 90 percent of the advisers who help write American Psychiatric Association guidelines had undisclosed financial ties to industry, Insel writes in JAMA.

Antidepressants and other drug treatments rack up multibillion-dollar annual sales while non-drug treatments such as therapy are "woefully underused," Insel writes.

Insel's commentary will be influential, said Dr. Emil Coccaro, psychiatry department chairman at the University of Chicago and a recipient of NIH grants. "It's important that our potential patients and their family members know we're above reproach in terms of undue influence by Big Pharma," Coccaro said.

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