The American Association of Clinical
Endocrinologists apparently likes to pick and chose its fights. They
did not attack Anne L. Peters, MD, CDE, Professor of Clinical
Medicine; Director, Clinical Diabetes Programs, Keck School of
Medicine, University of Southern California, Los Angeles, California.
Yet, they pulled out all stops to clash with Jerry Avorn, MD,
Professor of Medicine at Harvard Medical School and Chief of the
Division of Pharmacoepidemiology and Pharmacoeconomics in the
Department of Medicine at Brigham and Women’s Hospital.
Therefore, I would be inclined to
believe Dr. Avorn struck a raw nerve in his criticism of AACE's
business ethics and they could not let that go without a denial for
posturing position. Dr. Avorn stated in his New York Times op-ed piece, “The A.A.C.E.’s latest guidelines elevate many second-
or third-line drugs to more prominent positions in the prescribing
hierarchy, rivaling once uncontested go-to medications like
metformin, an inexpensive generic. They also emphasize the riskiness
of established treatments like insulin and glipizide, which now carry
yellow warning.”
This is something to consider and I
missed this point in my discussion here. Dr. Avorn also states in
his New York Times op-ed piece, “But there is also concern that
they could have been influenced by another factor: the manufacturers
of some of these new drugs financially supported the development of
the guidelines, and many of the authors are paid consultants to some
of those companies.” I agree, as there was too little
information published with the AACE Diabetes Algorithms and nothing
stating how they were developed and if others had approved them.
When something is just published with little additional information
except some press and quotes from a Dr. Garber, criticism should be
expected.
When you know that they have many
corporate-partners in the pharmaceutical ranks, the denial of what
Dr. Avorn says holds no water and clearly is done to appease the
corporate ranks. Review the corporate-partners list here. If you
carefully read this denial on the AACE website, they only deny
corporate funding of the algorithms, but make no denial of the
consulting fees paid by corporate-partners. There may have been a
healthy bonus in their consulting pay. How else could these
“experts” have, “Donated days of time
and talent to accomplish what they value as an important component of
public health.”
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