Call for Full Disclosure of Australian Committee Members Vested Interests.

The Royal Australasian College of Physicians Draft ADHD Guidelines have been halted under a cloud of controversy as it was revealed that US psychiatrist, Dr. Joseph Biederman, is currently under U.S. Congressional investigation for his undisclosed financial ties to the pharmaceutical industry. Dr. Biederman, whose studies are cited more than 70 times in the draft ADHD guidelines, has confessed to receiving up to US$1.6 million to research and promote specific drugs, clearly a conflict of interest.

The Guidelines were being developed by a committee with financial ties to drug companies that produce the very drugs that appeared as the first line of treatment for ADHD in the draft guidelines. Full disclosure to the public of any vested interests of the Committee members drafting the Guidelines has never been made.

A Freedom of Information request by Australian Office of the Citizens Commission on Human Rights (CCHR) for the Vested Interest Disclosure Documents partially revealed the extent of drug company connections by Committee Members in attendance at the first meeting of the draft guidelines. Along with additional research it was found:

• Dr. Daryl Effron was Chair of the Committee until his conflicts were exposed in 2007 in The Daily Telegraph. He has been on the advisory boards of Novartis that makes Ritalin and Eli Lilly that manufactures Straterra – both drugs prescribed to treat ADHD. While standing down as Chair, he remained a Committee member.
• Dr. Patrick Concannon, has served on advisory committees for Novartis and Janssen-Cilag that makes the ADHD drug Concerta. See page 64.
• Professor David Hay is a Professor of Psychology at Curtain University of Technology West Australia and Janssen-Cilag the makers of the ADHD drug Concerta, has funded his presentation at educational seminars.
• Committee member, Ms. Michelle Pearce who is on the Education Group of the Committee, helped write a booklet, “Teenagers with ADHD” for Novartis.
• Professor Loretta Giorcelli from NSW, who is also on the Education Group of the Committee appealed against the release of the disclosure documents and when they were released she disclosed at the first meeting that she had received expenses plus accommodation to attend a meeting as an educational advisor paid for by Janssen Cilag who make the ADHD drug Concerta.
• Consumer Advocate, Geraldine Moore from Victoria wrote a book on ADHD and the catering at the launch of this book was funded by Eli Lilly who make the ADHD drug Strattera.
• Professor Philip Hazel, Clinical Director of the Centre for Mental Health Studies in the Hunter NSW attended the first meeting for the drafting of the ADHD Guidelines and according to his disclosure documents he has been on advisory boards of Eli Lilly who make the ADHD drug Strattera, Novartis who make Ritalin, Shire, Jansen and Pfizer.
• Michelle Toner from Learning and Attentional Deficit Society in WA also attended the first meeting and disclosed that her organisation had received limited and unrestricted grants from Eli Lilly, Janssen-Cilag and Novartis.
• Jude Foster the director of the Wraparound Kids Program attended the first meeting and she also appealed against release of her documents. When they were released her document dated 1/03/07 stated she was a member of the Advisory Board for Novartis and Janssen Cilag- both drug companies who make ADHD drugs. Despite this her Wraparound Kids Program is listed as a “Resource” for Teachers in the Draft Guidelines.

The Committee reported that it analysed 265 studies in the Draft Systematic Review document which was then used to write the Guidelines. A total of 89 or 31% of these “studies” were industry funded. By way of example, Russell Barkley, Ph.D., a renowned proponent of “ADHD” and stimulant treatment, has more than 30 studies referenced. In 2007, almost a quarter (24%) of his income was from drug companies. He is a key advisor to the U.S. Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD) that U.S. media in 2006 exposed for its conflicts of interest with the pharmaceutical industry and the fact that it does not publish critical information about ADHD drugs, including an FDA warning in 2005 that the ADHD drug, Straterra, caused suicide. Eli Lilly, the maker of Straterra is one of CHADD’s biggest donors.

A key point still not disclosed, is the names of pharmaceutical companies or amounts of money paid, nor does it reflect the personal money industry researchers like Dr. Biederman received as paid advocates of the pharmaceutical industry – essentially marketing of mental disorders to sell drugs.

The studies picked by the Committee were clearly biased towards proposing drug treatment as the first line treatment activity and do not reflect contrary findings, including:

In 2005, researchers at the Evidence-based Practice Center of Oregon Health & Science University reviewed 2,287 studies of 16 ADHD drugs, representing virtually every study ever conducted on ADHD drugs, and determined that no trials had shown the effectiveness of current ADHD drugs. They also found a lack of evidence that these drugs could affect academic performance, risky behaviors, social achievements, etc. The Draft Guideline left this vital document out of its recommendations.

“There must be full disclosure and total transparency of any vested interests of the Committee drafting the Guidelines otherwise the public will have absolutely no faith in them. Already they are a cesspit of vested interests. What other vested interests have not been disclosed?” asks Shelley Wilkins, Executive Director of the Australian National Office of CCHR.

Australia has the third highest rate of Ritalin consumption in the world behind Canada and the United States. Ritalin is a pharmacologically similar to cocaine.

“With Australian ADHD drug prescriptions increasing at an annual rate of nearly 12% and the vested interests of the Committee responsible for drafting these ADHD Guidelines, Australian children are set to suffer even more harmful side-effects form these drugs,” stated Ms Wilkins.

The Therapeutic Goods Administration has already reported 863 suspected adverse reactions to ADHD drugs. These include the sudden death of a 7 year old and a 5 year old that suffered a stroke after taking Ritalin.

For further information please contact CCHR, which was co-founded by the Church of Scientology & Professor of Psychiatry, Dr Thomas Szasz in 1969 to investigate psychiatric violations against human rights.

1. Clinical Excellence Commission Report: “Attention Deficit Hyperactivity Disorder in Children and adolescents in New South Wales- 2007. Final Report of the Special Review, December 2007,” page 64.
2. Neilson Martin, Megan McDougall and David A Hay, “What are the key directions in the genetics of attention deficit hyperactivity disorder,” Child and Adolescent Psychiatry 2008 in press.
3. Freedom of Information Request done by Citizens Committee on Human Rights to the Australian Department of Health and Ageing. Documents released to CCHR on 12 December 2008.
4. Freedom of Information Request done by Citizens Committee on Human Rights to the Australian Department of Health and Ageing. Documents released to CCHR on 15 September 2008.
5. Freedom of Information Request done by Citizens Committee on Human Rights to the Australian Department of Health and Ageing. Documents released to CCHR on 15 September 2008.
6. Freedom of Information Request done by Citizens Committee on Human Rights to the Australian Department of Health and Ageing. Documents released to CCHR on 15 September 2008.
7. Freedom of Information Request done by Citizens Committee on Human Rights to the Australian Department of Health and Ageing. Documents released to CCHR on 8 January 2009
8. Royal and Australasian College of Physicians Guidelines on Attention Deficit Disorder Draft for Public Consultation 2008, page 130.
9. Russell A. Barkle, Ph.D., Official Site, http://www.russellbarkley.org/about-dr-barkley.html
10. Thomas Ginsberg, “Donations tie drug firms and non-profits; Many patient groups reveal few, if any, details on relationships with pharmaceutical donors,” The Philadelphia Enquirer, 28 May 2006.
11. “Drug Class Review on Pharmacologic Treatments for ADHD,” Final Report, Evidence-based Practice Center of Oregon Health & Science University, Sept. 2005; M. Alexander Otto, “Are ADHD Drugs Safe? Report Finds Little Proof,” The News Tribune, 26 Sept. 2005.
12. Clara Pirani, “Children on ADHD drugs hit by heart attacks and stroke,” Weekend Australian, 27 Mar. 2006.