Galleri / GRAIL, multi cancer detection tests, and friends in high places

free access in the BMJ

https://www.bmj.com/content/386/bmj.q1706

By me and Deborah Cohen.

It’s the story of how a rich, well connected company ends up with a contract to run a trial in the NHS. (also interviewed for the BMJ Podcast).

To be seen in context with our other story on Inclisiran, and research on conflicts of interest and screening for AF.

Bottom line: The NHS created systems to try and stop poor quality evidence (with a high risk of bias, conflicted interests, etc) getting into practice and harming patients and taxpayers. But a whole other ecosystem tries to override these safety catches - put into place to try and stop bad practice - to serve their own interests.

The new Labour government have made many statements on supporting the life sciences industry. But remember: the UK set up NICE and the UK National Screening Committee because of multiple poor quality decisions around healthcare use (actual and potential), much of which did harm and wasted money. For these organisations to work properly, they have to be independent, unlobbied by government, free of conflicts of interest, and cherished as guardians of evidence based medicine. It should be a win/win to a government not wanting to make unpopular decisions on funding - yet, it seems that in governments recently past, these organisations became an obstacle to certain desires.

Watching this space.