The EPA, charged with protecting the public welfare and keeping harmful and deadly chemicals from entering the marketplace, has become more of a mediator between chemical companies and environmentalists: it does not have the funding, for example, to research the chemicals on the market, so it relies on tests and research performed by the companies on their own products to determine whether or not the chemical is dangerous.
In 1991, the EPA offered amnesty to chemical manufacturers that turned in health studies and research they should have provided to EPA earlier—the EPA offices received more than ten thousand studies that indicated the chemicals on the market could pose “a substantial risk of injury to health or the environment.” This is the kind of data that, by law, corporations must present to the government immediately.
But it’s the story of the FDA that is truly salacious: rocked by controversy over the last few years, the FDA has become the most highly-politicized government agency in federal government. In 2004, The FDA rejected an application from pharmaceutical company Barr Pharmaceuticals to make Plan B, the morning-after bill, available to consumers over the counter. The rejection came after the FDA’s scientific advisory board voted overwhelmingly (23-4) to approve the switch. As Michael Specter reported in The New Yorker, “the agency had never rejected a similar request against the advice of its scientific advisers and its own staff.”
In fact, over the past five years, the agency has demonstrated an overall disregard for the recommendations made by its scientific advisors. The New England Journal of Medicine accused the FDA of making “a mockery of the process of evaluating scientific evidence” and that it had “squandered the public trust and tarnished the agency’s image.” USA Today found that while federal law prohibits the FDA from using experts with staked interest in companies seeking approval, the agency has waived that law nearly a thousand times since 1998. The reason, according to the agency, is that there are simply no good researchers without industry connections. The financial connections between industry and science are pervasive. But in 1992, the FDA stopped making details of financial conflicts among its advisory board members and the companies seeking approval; that year, the agency had been rocked by controversies over conflicts of interest regarding decisions on breast implants, Prozac, and other medicines.
The EPA’s review process of hazardous chemicals relies on research conducted by the chemical companies on their own products to determine its level of safety and its effects on the environment and on populations. For the FDA’s review process, more than half of the experts hired to advise the federal government on the safety and effectiveness of medicine have financial relationships with the pharmaceutical companies whose medicines are up for review. USA Today found that while federal law prohibits the FDA from using experts with staked interest in companies seeking approval, the agency has waived that law nearly a thousand times since 1998.
Why? Because there is now a catch-22: the “best” scientists are often employed by, or at least consultants to, interested companies coming before these boards; these scientists are leaders in their fields. Yet at the same time, by having a financial interest in the companies for which they consult, and for the companies seeking FDA approval and avoiding EPA regulation, objectivity is unavoidably in question.
Financial conflicts include stock ownership, consulting fees, research grants, a spouse's employment and payments for speeches and travel. The conflict could be a tie to the company whose drug is under consideration or to a company that sells a competing drug.
Protocols are particularly important. With FDA approval the pharmaceutical Holy Grail, companies may work for years on the development of a medicine, investing millions of dollars hoping for a huge pay day once the product hits the market. A company seeking this approval often designs a clinical trial in its own research division and brings in independent investigators, in that field, to oversee the protocols, or sometimes even to design the study in its entirety. Or at least that’s the way it used to be. More and more, companies are writing the protocols themselves, then bringing in investigators, even though they have no intention of changing the study design. What does this mean? It means that companies will test a drug on a healthier and younger population than the population most expected to use the drug in the real world. Companies’ marketing departments—which play a crucial role in decisions about which research studies will be conducted on a product—often nix clinically important studies if the results might reduce sales of the drug or jeopardize FDA approval.