Doctors who take pharmaceutical money often use Twitter to hype drugs

Some cancer doctors use Twitter topromote drugs manufactured by companies that pay them, but theyalmost never disclose their conflicts of interest on the socialmedia platform, a new study shows.

"This is a big problem,"said senior author Dr. VinayPrasad, a professor at Oregon Health and Science University inPortland. "Doctors are directly telling patients about theirviews on drugs, and financial conflict plays a role. But they're not telling patients they have a conflict."

Prasad and his colleagues analyzed the tweets and income ofblood cancer specialists who posted regularly on Twitter andreceived at least $1,000 US from drug manufacturers in 2014.

Of the 156 hematologist-oncologists in the study, 81 per centmentioned at least one drug from a company that gave them money,and 52 per cent of their tweets mentioned the conflicted drugs,according to a study reported in a letter in The Lancet.

Only two of the doctors disclosed that they receivedpayments from the drug companies whose products they mentionedon Twitter.

Cancer drugs tend to be toxic, produce debilitating side-effects and are frequently only marginally effective, Prasadsaid in a phone interview.

Inform audience of possible bias

Pharmaceutical companies routinely pay doctors to assesstheir products and to speak at conferences and seminars.

Bioethicist Susannah Rose, who was not involved with thestudy, said it "yet again shows the complex issues related tophysicians' financial relationships with industry."

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She urged disclosure, possibly in physicians'Twitterprofiles, about conflicts of interests.

Rose, who is scientific director of research for theCleveland Clinic's office of patient experience in Ohio and wasnot involved in the study, suggested in email to Reuters Healththat doctors should use a common abbreviation in their tweets toindicate conflicts of interest.

'Maybe we can learn something from celebrities here'

Celebrities use the hashtag #sponsored when they tweet aboutproducts from companies that pay them, Prasad said.

"Maybe we can learn something from the celebrities here," he said.

Genevieve P. Kanter, a professor of research at theUniversity of Pennsylvania Perelman School of Medicine inPhiladelphia, said she was surprised that hardly any of thestudied doctors disclosed their payments from drug companies.

"If a doctor is promoting a drug whether it's at apresentation, at a conference, through an op-ed or via a tweet the audience should be informed of possible biases that mightcome from being financially supported by the company producingthat drug,"she said in an email.

Doctors, consciously or unconsciously, may be "shading theirspeech or their actions because of their dependence on certainincome sources,"said Kanter, who was not involved in the study.

Rose advises patients to ask their doctors about possibleconflicts of interest. In the U.S., patients can look upphysicians' relationships with drug manufacturers on agovernment website: http://bit.ly/2wVGWsS.

Kanter suggested that patients who learn their doctors haveconflicts of interest consider getting a second opinion.

Prasad began thinking about conflicts of interest in tweetsa few years ago, when he got into a Twitter dispute aboutwhether physicians should engage in a debate over drug costs.

As the argument heated up, Prasad divided the duelingdoctors into two camps those in favour of discussing the priceof drugs and those opposed. Then he looked up which ones tookmoney from drug companies.

Of five physicians who argued that doctors should advocatefor lower drug costs, only one had taken money from a drugcompany, and it was a single $400 payment. The five who arguedthat doctors should stay out of the discussion of drug priceshad taken payments of between $20,000 and $30,000, Prasad said.

Earlier this year, Prasad published his first study ontweeting doctors. Nearly 80 per cent of more than 600 U.S.hematologist-oncologists who tweeted had a conflict, his reportin JAMA Internal Medicine found.

Doctors should disclose possible conflicts in their Twitterprofile biographies, possibly with a link to more complete
disclosure, Prasad and his colleagues wrote in the earlierstudy. When doctors tweet about products from companies withwhich they have conflicts, the researchers advised using thehashtag abbreviation for financial conflict of interest#FCOI.