Doctors Fail to Disclose Financial Incentives from Drug Companies
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A recent New York Times article stated that one of the nation’s most esteemed psychiatrists did not report approximately $1.2million of income he received from consulting arrangements with drug makers for a period of seven years. From 2000 to 2007, Dr. Charles B. Nemeroff of Emory University, earned over $2.8million according to documents being examined by Congressional investigators.
In 2004, Dr. Nemeroff signed a letter to Emory administrators promising that he would earn less than $10,000 a year from GlaxoSmithKline. If this were accurate, he would have complied with the federal rules. However, in 2004, Dr. Nemeroff actually earned $170,000 from GSK.
Republican Senator Charles E. Grassley of Iowa is leading the inquiry.
"After questioning about 20 doctors and research institutions, it looks like problems with transparency are everywhere," Mr. Grassley said. "The current system for tracking financial relationships isn't working."
The main problem, suggested by the current Congressional findings, is that universities are failing to monitor their faculty members’ conflicts with the drug companies.
In response, Mr. Grassley has sponsored the Physician Payment Sunshine Act that would require public disclosure by drug and device companies of payments to doctors over $500.
While the National Institute of Health does have strict rules regarding conflicts of interest, it relies on universities to police the situation.
What does this mean for patients and individuals relying on studies or findings from universities concerning drugs or medical devices? Well, it certainly leads to a loss of objectivity and perhaps honesty in the conclusions reached about certain products. For example, in 2006, Dr. Nemeroff, citing a clerical error, failed to disclose his financial ties to Cyberonics. Cyberonics made a device that Dr. Nemeroff and his colleagues favorably reviewed in one of the journals he edits.
The Cyberonics paper led to a bitter e-mail exchange between Dr. Nemeroff and Claudia R. Adkison, an associate dean at Emory, according to Congressional records. Dr. Adkison noted that Cyberonics had not only paid Dr. Nemeroff and his co-authors but had also given an unrestricted educational grant to Dr. Nemeroff's department.
"I can't believe that anyone in the public or in academia would believe anything except that this paper was a piece of paid marketing," Dr. Adkison wrote on July 20, 2006.
This revelation has led many institutions to consider reevaluating these relationships and maybe going so far as to bar doctors from lecturing about drug/device marketing.
As concerned patients who may be affected by these drugs and medical devices, here is some information on prescription drugs. As the inquiry continues and changes are made, hopefully we can be assured that in the future, financial incentives will never again replace honest and objective research.