A DSMB is a group of scientists who are not investigators in a study, but who are charged with periodically reviewing the data and results of a study, with the responsibility of stopping the study before its planned endpoint if the data shows that one group or another is being harmed or suffering an unusual number of deaths or injuries. In the late 1990's Merck was funding a study comparing Vioxx, an investigational drug at that time, with naproxen, an already approved anti-inflammatory drug. The NPR report charges that the DSMB should have stopped the study early and reported an increased risk of heart attacks in Vioxx users, but they did not because, the report implies, some members of the DSMB, including its chairman, had financial interests in Merck. (Interestingly enough, the report does not come down too hard on Merck itself. The story almost seems to assume that a big drug company will be motivated by corporate greed and cannot be expected to do the correct ethical thing - such as stop a study if need be.) An FDA scientist estimates that between 1999 and 2004, 38,000 people died from heart attacks caused by Vioxx, deaths that could have been prevented if the information about Vioxx causing heart attacks came out in 1999 instead of 2004.
Far be it from me to wish to defend a corporation so motivated by profits that it withholds vital safety information. But I don't really know what went on in the heads of the DSMB members, and it is only fair to point out that a DSMB has a very tough job. When studies are planned, the number of subjects needed to show a certain degree of benefit is carefully calculated. Stopping a study early may mean that a benefit of a drug is not demonstrated because not enough patients were enrolled.
Not too long ago there was a large, multicenter study comparing premature newborns given hydrocortisone, a type of steroid, shortly after birth with those given a placebo, primarily to see if there was less lung disease in the hydrocortisone treated patients. The study was stopped early by its DSMB because the hydrocortisone treated babies had a higher chance of a gastric or intestinal perforation, basically a hole in the stomach or intestine. Some people were critical of the decision to stop the study early, fearing that a greater good of possibly finding a benefit to hydrocortisone treatment was nullified by a perhaps lesser safety concern.
If the study had proceeded to its conclusion, would we have found a benefit to hydrocortisone? Probably not. But there are two sides to everything - even if one of them is a large, hungry corporation.