How Industry Funds Medical Education
Of Harvard's 8,900 professors and lecturers, 1,600 admit that either they or a family member have had some kind of business link to drug companies — sometimes worth hundreds of thousands of dollars — that could bias their teaching or research. Additionally, pharma contributed more than $11.5 million to the school last year for research and continuing-education classes. The Times covered these details in its stories and included the damning fact that during the November demonstration, a Pfizer employee was on campus photographing protesters with a cell-phone camera. Pfizer did not deny the account but contended that the employee did nothing wrong. (See the top 10 scandals of 2008.)
The tug-of-war between industry and research is long-standing. Major medical journals require any doctors publishing work in their pages to disclose board memberships or other moneymaking arrangements they have with drug companies. Last summer, the Pharmaceutical Research and Manufacturers Association prohibited salespeople from treating doctors to meals and golf excursions and even banned the ubiquitous company-branded pens, mugs and notepads that clutter waiting rooms and reception desks. Just this week, federal officials revealed a newly aggressive plan to begin pursuing civil and criminal charges against doctors who accept kickbacks or demand speaking or consulting fees for prescribing drugs or medical devices.
But medical schools are a new low. After the Times stories were published, Senator Charles Grassley, an Iowa Republican and longtime critic of drug-company influence, fired off a letter to Pfizer chairman and CEO Jeffrey Kindler describing himself as "greatly disturbed" by the reports and accusing Pfizer of trying to "intimidate young scholars." Grassley cited the 149 Harvard professors or instructors who have received payments or benefits from Pfizer specifically and demanded a detailed accounting of all of them. He closed with a terse "I look forward to hearing from you by no later than March 10, 2009." Pfizer has pledged to cooperate. (Read "The Year in Medicine 2008: From A to Z.")
The outrage comes easily for Grassley and the students — and when it comes to doctors and professors accepting what look like legal bribes or drug companies strong-arming protesters, it should. But there are some gray areas. Medical-school professors get their jobs in the first place because they know their fields. Forbid such educated people to consult with the companies that develop new medicines and you cut off a valuable source of knowledge. What's more, pharma's largesse also flows to the schools themselves in the form of multimillion-dollar endowments. Whether or not the companies are trying to curry favor, they're also building labs and bankrolling scholarships — something that becomes increasingly important as the deteriorating economy causes philanthropic giving to dry up. No one disagrees that isolating academia from the industry may be ideal, but even many academics concede that the cooperation yields more good than harm.
The analysis of payments, made public through disclosures in scientific publications,found that, of 107 physicians who advised the FDA on 28 drugs that were approved between 2008 and 2014, the majority of them later received financial support — including direct payments for consulting, reimbursements for travel expenses, or other support for research — from the companies whose drugs they voted on.
That includes seven physicians who received over $1m (£750,000) in such financial support from the companies, 19 who received between $100,000 (£76,500) and $1m, 14 who received between $10,000 (£7,500) and $100,000, and another 26 who received between $1,000 (£756) and $10,000 in financial support. Forty-one physicians or advisers received no payments or financial support from the companies they voted on.
One of those physicians identified in Science Magazine’s report is Jonathan Halperin, a cardiologist with Mount Sinai in New York. Mr Halperin, who received at least $2.1m (£1.59m) in financial support from pharmaceutical companies like AstraZeneca, disputed the notion that after-the-fact payments for consulting or in support of research influenced his decision making process.
Mr Halperin further noted that he did not receive direct benefits from the $1.9m (£1.44m) AstraZeneca provided to Duke University, where he chairs a data monitoring committee for pharmaceutical research. But, he indicated that the relationships like his with pharmaceutical companies and those tasked with overseeing the FDA’s drug approval process may be the price to pay for expertise.
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