Translational Medicine: Bridging the Gap (Part 2)

 

Efforts to bridge this gap between clinical and medical research and clinical practice are ongoing. 

For example, translational research centres aim to reduce the time from bench to bedside by fostering collaboration between scientists, clinicians, and public health experts. Additionally, the use of implementation science—the study of how to integrate research into practice—seeks to identify the most effective ways to overcome these barriers.

I think one of the other reasons as to why research findings seldom get translated into clinical practice is blockage by those powerful Big Pharma companies who may not be very happy if other alternative options to manage a disease have been discovered instead of using drugs.  

We need to look at the role of large pharmaceutical companies, or "Big Pharma," in the translation of medical research into practice. While pharmaceutical companies play a critical role in developing and distributing medicines, there are concerns about how their business interests might sometimes conflict with the broader goals of public health and scientific advancement. There are a few reasons on this we can think of

 Profit Motives and Market Control

Profit-Driven Models. Big Pharma companies often prioritize treatments that will generate the highest profits, which may sometimes lead to a focus on chronic disease management (where long-term drug use is required) rather than cures or alternative treatments. If a new approach threatens the market share of a lucrative drug, there could be less incentive for a company to promote that alternative.

Patents and Exclusivity.  Pharmaceutical companies rely heavily on patents to secure market exclusivity for their products. This can lead to strategies aimed at extending the life of a drug patent (e.g., minor reformulations), rather than focusing on newer, potentially more effective alternatives. They may also suppress or ignore research that threatens to undercut their patented products.

1.      Influence on Research and Publication

Research Funding.  Big Pharma often funds a significant amount of biomedical research, especially clinical trials. While this can lead to breakthroughs, there is concern that results could be influenced or shaped by the interests of the funding company. Some research might be suppressed or not published if it doesn't align with a company's goals.

2.      Publication Bias. There is evidence of publication bias, where positive findings (especially in favour of pharmaceutical products) are more likely to be published, while negative or neutral results are withheld. This can distort the evidence base available to clinicians.

Ghost-writing and Influence. Sometimes, pharmaceutical companies engage in ghost-writing practices, where industry-sponsored research is written by the company but attributed to independent researchers. This can further blur the line between objective research and commercial interest.

3.       Suppression of Alternative Treatments

Alternative Therapies. If research uncovers non-pharmaceutical interventions—such as lifestyle changes, dietary supplements, or natural remedies—that could reduce the need for drugs, pharmaceutical companies might view these as a threat to their business model. While it’s hard to prove outright suppression, it’s possible that companies might not promote or fund such research aggressively.

Lobbying and Policy Influence: Big Pharma companies often have significant influence over healthcare policies through lobbying efforts. This can shape drug approval processes, clinical guidelines, and even insurance coverage policies in ways that prioritize pharmaceutical solutions over alternative therapies.

4. Ethical Concerns

Ethical Dilemmas.  The potential suppression of alternative treatments raises ethical concerns. While pharmaceutical companies are in the business of developing effective treatments, their primary duty is to shareholders. This profit motive can sometimes conflict with the goal of maximizing patient health, especially if alternatives exist that are not as profitable.

Whistleblowers. There have been cases where whistleblowers within the pharmaceutical industry have revealed unethical practices, such as the suppression of unfavourable trial results or the manipulation of data. However, these are often the exception rather than the rule.

5. Balancing Regulation and Innovation

Regulatory Oversight. Governments and regulatory bodies (like the FDA) aim to ensure that the pharmaceutical industry operates in the public interest, but regulatory capture—the phenomenon where industry interests dominate public oversight—can sometimes occur. Stronger regulatory frameworks could help to ensure that promising treatments, whether pharmaceutical or alternative, reach the public.

Academic Independence. To counterbalance Big Pharma’s influence, academic research centres and independent funding bodies (such as government or non-profit organizations) are vital. They can pursue lines of inquiry free from corporate interests, but often lack the same level of funding.

6. Alternative Models Emerging

Open-Source Drug Development: To combat these issues, some researchers advocate for open-source drug development, where research results are freely shared and not tied to corporate interests. This model could allow for greater collaboration and innovation, especially in neglected disease areas or alternative therapies.

Publicly Funded Research.  Increasing public investment in medical research, rather than relying so heavily on private companies, could help ensure that results are translated into practice based on scientific merit rather than commercial potential.

While Big Pharma’s business model can, at times, create barriers to the adoption of alternative treatments, there are also ongoing efforts to promote transparency, ensure unbiased research, and prioritize patient care.

What do readers think about the role of regulatory bodies or public funding in addressing some of these challenges?

 Based on my own experience in medical research, before research papers can be published, the board of editors of scientific journals require the researchers to declare the source of funding. But what happens if the papers were actually funded by these giant pharmaceutical companies? Will the papers be published?

Many scientific journals now require researchers to disclose any conflicts of interest, including the source of funding, especially when it comes from pharmaceutical companies or other corporate entities. This practice is meant to enhance transparency and help readers assess whether the funding source might have influenced the research findings or their interpretation.

What Happens When Pharmaceutical Companies Fund the Research?

Disclosure Requirements.

Researchers are required to declare conflicts of interest, which includes detailing the financial support they received for the study. This helps journals and readers understand any potential biases.

Some journals have strict policies and will reject a paper if there is a lack of transparency in funding disclosure, or if there is suspicion of biased reporting.

1.      Publication of Pharma-Funded Research.

Yes, pharma-funded research can be published, but journals tend to be more rigorous when reviewing these studies. Editors and peer reviewers will often pay close attention to the study design, data transparency, and interpretation of the results to ensure the research isn’t skewed to favour the funding company.

Journals may also require independent validation of the findings, such as external reviews or replication studies, to further safeguard the integrity of the published results.

2.      Potential Issues with Pharma-Funded Research:

Bias in Study Design. One of the concerns with pharmaceutical-funded research is that studies might be designed in ways that favour the drug being tested. For example, comparison groups might not be fair (comparing a new drug to a placebo rather than to an existing treatment).

Selective Reporting. Pharmaceutical companies may selectively report positive outcomes while downplaying or omitting negative findings. While this is a recognized problem, peer reviewers are increasingly looking for signs of such selective reporting.

Ghost-writing: Sometimes, pharmaceutical companies sponsor papers that are written by individuals associated with the company, but the final version is attributed to external experts (ghostwriters). This practice is controversial, and many journals now have policies to prevent it.

3. Journal Safeguards Against Bias:

Peer Review Process. Many journals require rigorous peer review, where independent experts in the field assess the validity and credibility of the study. Peer reviewers are generally tasked with checking for any potential biases, especially when research is industry-funded.

Data Transparency. Journals may ask for full access to the data to verify the findings. Increasingly, researchers are being asked to share their raw data in public repositories for verification.

Ethics and Reproducibility.  Journals are placing more emphasis on ethical research practices and reproducibility. Independent replication of results is one of the most effective ways to ensure research integrity.

4. Impact on Perception:

Even if a paper discloses its funding and follows all ethical guidelines, research funded by pharmaceutical companies may still be viewed with scepticism by the scientific community. This is because of past instances where industry-funded studies were found to be biased or inaccurate.

To mitigate this, researchers often strive to demonstrate that their methodologies are rigorous, and their findings are unbiased, no matter the source of funding.

Recent Developments

To improve transparency and reduce conflicts of interest.

Some journals now ask for third-party oversight of clinical trials funded by pharmaceutical companies. This ensures that the data analysis and interpretation are not solely in the hands of the company.

Pre-registration of trials is becoming common, where researchers must publish their study design and hypotheses before collecting data. This prevents "cherry-picking" results after the fact.

Open-access journals with independent funding models are emerging, aiming to reduce industry influence altogether.

While pharmaceutical-funded research can be published, the key is ensuring that the study's methodology and reporting are transparent, unbiased, and reproducible. I am interested in how the peer review process works in detail or examples of cases where bias was identified in pharma-funded studies?

Let alone research papers published in journals, even the treatment of any disease given in standard medical textbooks we see all the products of these drug companies clearly printed there. I have in my home library about a dozen medical textbooks by various authors, and under management or treatment in the last page of every disease described in each chapter, the names of Big Pharma products are clearly printed there, often as "the drug of choice". Such relentless promotion of drugs by these powerful drug companies firmly glue the mindset of doctors to use these "drugs of choice" for treatment. Doctors have no choice. However, there are now a lot of other medical books on alternative systems of medicine written by various medical authors who are qualified both in conventional as well as in other systems of medicine. There are also standard textbooks on integrative medicine contributed collectively by several dozens highly qualified specialist doctors in allopathic as well by doctors in alternative medicine where drug-based therapies has been replaced by other therapeutic modalities such as in osteopathic, naturopathic, mind-body medicine, and back to the original dietary and botanical medicine among other medical systems. This is the trend now used by a lot of people who got disgruntled with allopathic medicine where they have been taking pharmaceutical drugs for life, but has not cured them 

Drug-based allopathic medicine was started by that oil multi-billionaire Rockefeller over a 100 years ago who started to replace natural medicine with his petroleum products as medicines till this day.

The influence of the pharmaceutical industry on both medical research and medical education has a long history, and the Rockefeller family's role is indeed a significant part of that narrative. Let me show you how this shift unfolded and its lasting impact on modern medicine:

1. Rockefeller's Influence on Modern Medicine

Early 20th Century Shift. In the early 1900s, John D. Rockefeller, one of the wealthiest individuals of the time due to his oil empire, played a pivotal role in shaping modern medicine. Rockefeller was a strong advocate of allopathic medicine, which focused on using pharmaceutical drugs and surgery to treat illnesses, as opposed to traditional or natural remedies like herbal medicine or homeopathy.

Petroleum-Based Pharmaceuticals. Rockefeller's company, Standard Oil, had a vested interest in petrochemicals, and this coincided with the rise of synthetic medicines derived from petroleum by-products. These synthetic drugs began to replace many natural remedies and herbal treatments that had been used for centuries.

2. Flexner Report and Medical Education Reform

The Flexner Report (1910).  A major turning point was the Flexner Report, funded by the Rockefeller Foundation, which evaluated medical schools in the United States. The report was highly critical of many schools, particularly those that taught alternative medicine, and recommended adopting a more scientific approach to medical education—based heavily on pharmaceutical treatments.

Medical School Funding.  Rockefeller, along with the Carnegie Foundation, provided significant financial support to medical schools that followed this new model. As a result, many schools that emphasized natural or holistic medicine were closed, while those that aligned with the new pharmaceutical-based approach flourished.

3. Rise of Pharmaceuticals in Medical Practice

Pharmaceutical Companies' Influence. Over time, the pharmaceutical industry became deeply embedded in both medical education and clinical practice. Medical textbooks, training, and curricula began to emphasize pharmaceutical treatments as the primary method for treating illnesses, often sidelining traditional or natural therapies.

Pharmaceutical Advertising. Drug companies began to sponsor medical textbooks, conferences, and even the continuing education of doctors. As a result, many standard medical textbooks today prominently feature pharmaceutical products, often alongside treatment guidelines.

4. Shift from Natural Medicine to Synthetic Drugs

Suppression of Natural Remedies. As the pharmaceutical industry grew, many natural remedies and traditional medicine practices were marginalized or dismissed as "unscientific." This shift was partly driven by the financial interests of the growing pharmaceutical companies, which saw greater profit potential in patented, synthetic drugs.

Regulation of Natural Medicines. In many cases, natural remedies were pushed out of mainstream medicine due to stricter regulatory requirements for drugs. Without the financial backing to go through rigorous clinical trials, many traditional medicines couldn’t compete with synthetic drugs produced by Big Pharma.

5. Current Impact on Medical Education and Practice

Drug-Focused Medical Education.  Even today, the curricula of most medical schools around the world place a heavy emphasis on pharmaceutical treatments. Pharmaceutical companies often fund research at academic medical centres, which can shape the knowledge that future doctors are exposed to.

Textbook Content. Medical textbooks often list brand-name drugs and treatments prominently. Pharmaceutical companies sometimes provide funding or support for these publications, further entrenching their influence in clinical guidelines.

6. Rockefeller’s Lasting Legacy in Modern Healthcare

Philanthropy and Control. The Rockefeller Foundation has been a significant force in funding medical research, public health initiatives, and medical education globally. While many of these efforts were beneficial in modernizing medicine and standardizing care, they also cemented the dominance of pharmaceutical treatments.

Public Health Influence. The Rockefeller Foundation helped shape global health policies through organizations like the World Health Organization (WHO) and the development of vaccines and public health campaigns, many of which focused on pharmaceutical interventions.

7. Resurgence of Interest in Natural Medicine

Alternative Medicine and Integrative Health.  Despite the dominance of pharmaceutical-based medicine, there has been a growing movement in recent years toward integrative medicine, which combines conventional treatments with natural and holistic approaches. Many patients and practitioners are now advocating for a more balanced approach to healthcare that includes both pharmaceutical and natural treatments.

Rise of Functional Medicine. Functional medicine, which seeks to treat the root cause of disease rather than just the symptoms, is gaining popularity. It often incorporates lifestyle changes, nutrition, and sometimes natural remedies, which are seeing a resurgence in patient interest.

The transformation of medical education and practice in the early 20th century, largely influenced by the Rockefeller family, shifted the focus from natural remedies to synthetic, pharmaceutical-based treatments. This legacy still shapes much of how medicine is taught and practiced today. While pharmaceutical advances have led to life-saving treatments, the sidelining of natural medicine has sparked a renewed interest in finding a balance between the two.

Currently medical doctors’ mind-set has been very firmly and very effectively imprisoned by these very powerful pharmaceutical companies. 

Clinicians believe that the only “cure” especially for chronic disorders, examples like diabetes and hypertension is to use chemical products for life produced by these giant drug companies, and not by addressing the root causes of diseases used in the current emerging lifestyle medicine that advocates changes in the ways patients live and eat and the use  of other more holistic natural therapies. 

See cartoon here: 

https://images.app.goo.gl/bmkE1gSgmjysXCvPA

In fact according to the World Health Organization (WHO) more than 80 % of the world population, including those from scientifically and technologically advanced countries like China, United States, United Kingdom, Japan, South Korea, Germany, etc., uses traditional or other alternative or integrated systems of medicine instead of conventional drug-based medicine. Furthermore, WHO encourages this, and wants this to stay as part of health care.

I believe I have written fairly comprehensively based on my understanding and experience in scientific-medical research over the years.  

I will cherish your thoughts and comments on this. Explain to me in clearly in elegant scientific language. Your contribution will be a world of difference for me. 

Take Care!

Ju-boo lim