Once again it’s just a little (three billion dollars ) off the top for Glaxo as it settles yet another illegal marketing case with the federal government.
Three billion is no biggie for big pharma, and the tons of other pending cases against Glaxo (all of which it will settle for large sums) are also no biggie. Your med school colleagues will continue getting lucrative sales gigs for Glaxo while they’re researching Glaxo drugs, etc. All will again be well as soon as this latest thing settles down.
And yet the head of a federal panel that will be issuing health guidelines for the rest of us has been unable to resist drug company money. She
has been a member of speaker bureaus for two drug companies, Daiichi Sankyo and Novartis. Some universities prohibit faculty involvement with speaker bureaus to avoid claims of marketing.
“The fact is you get pursued by the companies,” Dr. Oparil said. “On some occasions, I’ve said yes to them.”
The girl can’t help it.
Simon Stern and Trudo Lemmens, law professors at the University of Toronto, propose using the RICO Act to make university ghost and guest writers “think twice before allowing their names to be used.” They talk about the fraud on prescribers (of the drugs the articles promote), article readers, and patients.
What they don’t include is the fraud against their academic institutions. Every year, as they point out, professors submit annual reports to their deans, describing their research productivity. Pharma-fraudsters get monetary bonuses that should go to professors who write their own articles. This unfairness harms morale and collegiality; it also cheapens the institution by associating it with bogus, corporate-generated, research.
Universities, Lemmens and Stern write, “are reluctant to punish prestigious doctors who otherwise reflect credit on the institution and often help impress donors.”
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One thing that’s constantly amazed UD as she has written this blog is the way corporations pretty much do everything for faculty – not just write their articles. Chandru Rajam, recently a (not terribly well-received; too busy to teach… but who cares… just a visiting professor… only fucks up GW students for two semesters) colleague of UD‘s in the business school, has an outsourced grading business that will relieve UD of all grading responsibilities. She never needs to see a student paper! Add ghost-writing companies, corporate-provided PowerPoints (all you have to do is read them out loud! exam questions included!), etc. etc., and it’s clear that postmodern university professors who are willing to pay don’t have to do anything.
On top of this, UD lives in Washington – the richest metropolitan region in the country. While spending her money to make other people do everything for her, she has an immense variety of spas from which to choose.
Some of your med school colleagues routinely list three, four, five hundred publications on their cvs. And all you can do is gaze in wonderment at these superior creatures.
You owe it to yourself to learn about the massive ghost and guest (also known as honorary) writing industry in this country. Drudges – drawn from pharma-controlled ghostwriting companies or from underlings in the lab – do most or all of the writing for these creatures.
It’s quite the scam. And it ain’t going anywhere.
More than 600 biomedical journals have adopted guidelines for responsible and accountable authorship established by the International Committee of Medical Journal Editors, but previous research has found that the prevalence of honorary authors in articles is as high as 39 percent and the use of ghost authors as high as 11 percent.
As health care groups join Occupy Wall Street, a UD update on the practice of corporate ghostwriting among medical school professors.
Ghost authorship … involves deliberate suppression of the fact that [a scientific research article has] been written by someone other than the named author or authors.
In most cases of academic ghost authorship … an article is written by a professional medical writer who is commissioned or employed by a pharmaceutical company.
The name of this ghost author is suppressed and the only names that appear on the article are those of researchers.
These “authors” (sometimes referred to as “guest authors”) are often prominent academics who might have been involved in conducting the research, but not in writing the article itself.
Evidence [suggests that] approximately one in ten research articles submitted to major medical journals has a ghost author.
… if you’re looking for morally compromised faculty.
The student newspaper knows it.
…a Nation Institute Fellow who uncovered apparent conflict of interest and, ultimately, undisclosed outside income at the New York Times.
The Times Jerusalem bureau chief was also – until he dropped it as a result of Blumenthal’s article – a client of an Israeli speakers bureau. The firm pitched stories to the bureau chief, some of which he covered.
This was bad enough by way of giving the appearance of less than total objectivity on the part of a reporter covering an incredibly contentious part of the world. But Blumenthal’s piece also had the effect of uncovering other delinquency.
[Ethan Bronner] did not tell his editors about his relationship with Lone Star … because he did not think joining a speakers bureau had to be disclosed. Indeed, the ethics guidelines do not specifically require it. But the guidelines do require Times staff members to provide an accounting to editors if they earn more than $5,000 of speaking fees in a year. Mr. Bronner acknowledged he was “delinquent” in failing to do this, saying he believed he was obligated to account only for any single speech for which he was paid more than $5,000, another requirement of the policy.
Wow. So this guy believed that if he gave a bunch of speeches in a year, each of them pulling in five thousand – with a yearly total payment of, say, $150,000 – he didn’t have to declare this income to the Times because no one speech paid more than five thou.
He’s running a news bureau?
America, America. Can’t say we don’t know how to make money. Especially off of dying people.
I mean, you know, suck it up. You’ve got kidney disease, and you’re going to die… So you’re going to shell out the $23,000 for that little vial. Aren’t you?
Which is going to make one particular university professor very happy. Columbia University’s Andrew Bomback, in what sounds like the same form of business relationship Chip Skowron cultivated, has been talking to rich hedgies about his medical research… and it all has that je ne sais quoi, insidery tradery, feel to it, according to the state of Massachusetts.
Mr. Silverman [the hedgie], after talking with Dr. Bomback on June 14, 2010, invested $846,889 in Questcor [the company with the little vials] between July 6 and Sept. 9, the Massachusetts filing showed. He paid an average of $9.80 a share. The stock closed Friday at $27.27 a share, giving him a paper gain of $1.5 million.
UD‘s friend Paul Thacker is now a contributor to Forbes, and his first article shifts our attention from the recent University of Miami football scandal to the ongoing University of Miami Charles Nemeroff scandal.
Nemeroff – arguably America’s most conflict-of-interest-compromised professor – left Emory University under a vast black misconduct cloud, and was immediately, enthusiastically, hired by Donna Shalala at the University of Miami.
Thacker wants to know why. “Why would [UM] … snatch up a physician with such a history?” Why would they ask him to be part of a proposed new ethics center?
Indeed, UM seems to have perceived Nemeroff, with his years of COI problems, as an ethical model. Almost on the same day Shalala announced new rigorous COI standards for faculty, she announced the hiring of Nemeroff. An astounded former faculty member wrote to her:
[H]is seeming lack of integrity in simultaneously accepting “consulting fees” from the very company (Glaxo) whose products were the basis of an NIH grant on which he was the [Primary Investigator] is absolutely outrageous… [H]ow can one reconcile [your recent statements about new ethics policies] with the immediately prior hiring of so questionable an individual to such a prominent position? Does the university not perceive that this may be seen as the worst sort of hypocrisy?
Of course Shalala now has far more dire ethical – and criminal – preoccupations… Still, it isn’t hard to see her bizarre handling of Nemeroff as a kind of precursor.
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Scathing local coverage begins. Paul’s piece only came out about an hour ago.
Pharma loved Harvard because of its big ol’ name.
That has changed, as a Harvard professor who studies the interaction between industry and med school professors notes. “For a long time in medicine, not just at Harvard, but everywhere, there was a culture that said doctors were entitled to industry perks, but that culture is breaking down,” [Eric] Campbell said. “Doctors no longer assume it is their right and duty to accept these perks from industry.”
But hey. One school keeps the perk banner waving — and it’s UD‘s own GW!
“It’s just a rough environment,” said Dr. Lawrence DuBuske, [a Massachusetts] allergy specialist… “The industry wants very little to do with Massachusetts.”
DuBuske, who has been a top speaker for GSK and AstraZeneca about asthma medications, resigned from Brigham and Women’s last year, rather than give up his speaking appearances. Since then, he has landed a job at George Washington University School of Medicine and Medical Center in Washington, D.C.
Look. If you can’t make that campus attractive to people (UD has seen its palm-lined splendor), you’re not much of a president. Shalala did accomplish this.
Her problem is that she did it indiscriminately. She just looked at anything that might tart up the place and went there: football, Nemeroff:
The former secretary of health and human services raised some eyebrows when Miami hired Charles Nemeroff, a star researcher who left a previous job at Emory during a conflict-of-interest scandal, to lead the medical school’s psychiatry program.
Shalala swung wild and wide. And struck out.
Recent events in Libya have James S. Henry, in Forbes, returning to the question of high-profile, Gaddafi-enriched American professors acting as flacks – not only before the rebellion broke out but, for some of them, during it – for that regime. Henry charges that in exchange for large amounts of money from respectability-seeking Gaddafi, a group of amoral technocrats from some of our best universities used their respectable university affiliations to confer legitimacy upon a brutal dictator.
At the very least, some of these people muddied the distinction between consulting for the regime on things like best economic practices, and burnishing – air-brushing, in Henry’s word – its image. The Monitor Group, for instance, failed to register as what they were — lobbyists. They did so retroactively, under pressure from an outraged American public.
Using the symbolic power of the university to enrich yourself financially by conferring some of that symbolic power on others is an old game, and UD talks on this blog about the game’s many forms. UCLA makes a Milkin brother’s past all better by naming a business law institute after him in exchange for tens of millions of his ill-gotten goods. Yeshiva might have had its suspicions about the strange, remarkably lucrative relationship between Bernard Madoff and Ezra Merkin, but it took their money and conferred not only intellectual but religious respectability upon both of them by making them trustees. Vastly wealthy, vastly shady insider traders are being air-brushed as we speak. Several of them sit on university boards of trustees. They are hoping against hope that the Justice Department doesn’t do to them what it’s been doing to so many others. So are the universities harboring them because of their money.
The symbolic power of the university also confers goodness and seriousness upon corrupt athletes, coaches, and administrators. Amateurism, student athletes, a healthy body as well as a healthy mind, teamwork — pick your cliché. The extent to which large numbers of people continue to buy into these conceits – given the endemic filth of big-time university sports – is a measure of how powerful the symbolic power of the university continues to be.
The more impressive and famous the university – think Harvard – the more highly sought-after by wealthy miscreants trying to smell like a rose. But obviously what’s starting to happen is that the miscreants are transferring their stink to the university itself.
The university has always existed in a dirty seductive world. The reason people still refer to universities as ivory towers is that they are — or they’re supposed to be. They can’t be centers of serious legitimate thought – thought unbiased by powerful outside interests – if they’re always scurrying down the tower steps and closing this deal and then that deal to write what people on the outside with money and power want them to write.
The symbolic power of the university derives from its refusal to do this, its devotion to the pursuit of reasonably unvarnished, uncorrupted truth.
This is why conflict of interest and ghostwriting and all of that are such crucial subjects of this blog. When a colleague of UD‘s fails to disclose that a commercial interest – a business wanting to promote certain points of view about, say, the real estate market – has paid him for what he has written, we are rightly scandalized. When university professors let corporations ghostwrite their articles — to which these professors attach their names — we are rightly scandalized. The big dirty world is always knocking at the ivory tower doors offering money in exchange for legitimacy. It gets in a lot, too.
Politicians like Rick Perry help things along by ridiculing – as so many ordinary Americans routinely do – the whole “ivory tower” concept. Come down from your arrogant holier than thou bullshit and join the rest of us! What makes you special?
What makes the university special? If it continues selling off its definitive, much-sought-after asset, nothing at all.
[W]e medicate increasing numbers of children with potentially harmful psychotropic drugs, a trend fueled in part by questionable and under-regulated pharmaceutical industry practices. In the early 2000s, for example, drug companies withheld data suggesting that such drugs were more dangerous and less effective for children and teenagers than parents had been led to believe. The law now requires “black box” warnings on those drugs’ labels, but regulators have done little more to protect children from sometimes unneeded and dangerous drug treatments.
Universities should consider whether their medical faculties include people who, either through involvement in corporate ghostwriting, conflict-of-interest shilling for the pharmaceutical industry, or questionable experimental practices, are contributing to this vile trend by lending an impression of research neutrality to it. Don’t let your university be used in this way. As with the Joseph Biederman fallout at Harvard, it will ultimately hurt your school.
Under Shalala’s leadership, UM is changing the face not only of American university sports. It’s also contributing to important changes in the way scientific research is conducted in the United States.
It was to Shalala’s UM that Charles Nemeroff repaired after his problems at Emory. As the Chronicle puts it:
… Thomas R. Insel, who was helping to lead the [government’s conflict of interest] review, was also helping a tainted researcher, Charles B. Nemeroff, land a new job at the University of Miami.
Dr. Nemeroff, while chairman of the psychiatry department at Emory University, was one of several high-profile doctors found to have given speeches or written articles in medical journals extolling drugs or products made by companies that had paid them money or stock benefits that they did not report to their universities. Emory agreed to make Dr. Nemeroff ineligible for NIH grant money for two years. But after moving to Miami with the assistance of Dr. Insel, the director of the NIH’s National Institute of Mental Health, Dr. Nemeroff was receiving NIH money before the two-year ban expired.
Addressing the NIH’s advisory board after Dr. Insel’s assistance to Dr. Nemeroff was revealed, Dr. Collins said he would delay the process of putting the rules in place to consider additional changes. In particular, he said the rules may need to be changed to ensure that any penalties or sanctions against a researcher remain in effect if the researcher moves to another institution.
Smart move on Nemeroff’s part, by the way, to jump to the University of Miami. They’ll never give him any trouble. You can’t go any lower than UM.
Harvard University’s Joseph Biederman, world’s biggest bi-polar diagnosis booster, is making life a little difficult for his psychiatry colleagues at Mass General. Short version: You don’t want to be too closely associated with his antidepressants-for-tots drive, his undisclosed financial conflicts of interest, and his influential insistence that zillions of American children, teens, and adults are bi-polar.
So let’s say you’re Harvard’s Andrew Nierenberg, and you want to light into Marcia Angell because you’re pissed that she’s down on antidepressants. Of course, you concede in a letter attacking her arguments, it’s “heart-breaking” that there have been some cases in which nightmarish damage was done to children who were over- or mis-prescribed these very powerful drugs… But a case here or there should in no way lead us to suppose that the harmful dispensing of such drugs is a serious trend.
In her response, Angell points out the enormous influence Harvard, and Nierenberg’s colleague there (Joe), had on all those MDs giving all those children drugs. Biederman was – is! – the bi-polar man; he is almost singularly responsible for the astonishing inflation of pediatric bi-polar diagnoses and treatments in the United States in the last few years. Nierenberg co-authored papers, etc., with Biederman. Hence it’s a little on the disgusting side for Nierenberg to lecture us on the heartbreak of mis- and over-diagnosis without at least alluding to his own profoundly influential hospital’s financially compromised advocacy of the diagnosis.
Angell:
Nierenberg refer[s] to the death of Rebecca Riley, who was diagnosed with bipolar disorder as well as ADHD when she was just two years old, as a “tragic anecdote.” While that is true, I believe it should also be seen in the context of the extraordinary epidemic of juvenile bipolar disease that was stimulated largely by the teachings of some of Dr. Nierenberg’s colleagues [Biederman and two others] at the Massachusetts General Hospital. Three of them were recently disciplined by the hospital for not having disclosed some of their hefty payments from drug companies.
UD‘s advice to Nierenberg: Be like Australia. Distance yourself.