Medical 'education' companies funded by the pharmaceutical industry are threatening to undermine medical education in the US.

So says a report by the prominent American consumer advocacy group Public Citizen. It is estimated that these companies known as medical education service suppliers (MESS) are now being paid more than one billion US dollars a year to organise educational meetings and programmes, and to prepare educational material for doctors and medical students.

MESS, however, claims that it is simply filling a gap left by a government which won't provide continuing education and educational aids, and meeting the needs of institutions and physicians who dislike having to pay for them.

Public Citizen argues, however, that MESS exists simply to promote drug sales for its backers a claim that seems to be justified. Many MESS openly claim in their marketing material that such educational programmes are good for sales (Lancet, 2000; 356: 494).

Another recent report suggests that clinical trials funded by drug companies tend to be biased and may even be unethical.

The study examined 136 published randomised trials focusing on multiple myeloma (widespread bone marrow tumour), and compared the number whose results favoured new experimental treatments over standard forms of treatment.

At first glance, the studies appeared balanced in terms of their findings, with around half favouring each type of treatment.

But, when the data were reanalysed by funding source, nearly three quarters of the trials funded entirely or in part by the drug industry, compared with just 26 per cent of those funded by government or non profit organisations, came out in favour of the new experimental treatment under study.

Many of the drug company funded studies also appeared to be conducted purely in order to put some research behind a particular treatment. This is in opposition to the unwritten medical uncertainty principle that randomised trials should be conducted only if there is substantial uncertainty regarding the relative value of one treatment versus another (Lancet, 2000; 356; 635-8).