In Stephen Sheller’s book Lawyering In Times of Saints and Evil Doers (2015), Sheller tells the story of science for sale, the widespread conflict of interest created when doctors and researchers are influenced by payments they receive from pharmaceutical companies.
In 2008, a Congressional inquiry led by Senator Charles E. Grassley (R-IA) exposed the extensive conflict of interest between academic medicine and pharmaceutical companies. Prominent psychiatrist Dr. Charles B. Nemeroff was one of many academic researchers investigated after it had been discovered he failed to report to his employer, Emory University, $1.2 million in income from GlaxoSmithKline and other drug companies. Doctors for universities and research facilities who receive federal funding are required by federal law to report all possible conflicts of interest.
During the inquiry, Congress systematically requested the nation’s leading researchers to provide their conflict-of-interest disclosures. When these disclosures were compared to drug companies records of payment, there were often conflicting amounts, some significant.
“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 inquiry also investigated world-renowned Harvard child psychiatrist Dr. Joseph Biederman whose work was largely responsible for the significant increase in the use of antipsychotic medication in children. Although Biederman’s studies were small and financed by drug companies, his work helped to fuel the controversial 40-fold increase in diagnoses of pediatric bipolar disorder between 1994 and 2003. Biederman had failed to disclose more than $1.6 million in consulting fees from drug companies including fees earned from Johnson & Johnson, makers of the antipsychotic drug Risperdal.
Biederman played a key role in pediatric use of Risperdal, detailed by Huffington Posts’ DocuSerial “America’s Most Admired Lawbreaker.” The DocuSerial profiles Stephen Sheller’s litigation against Johnson & Johnson for the injuries cause to young boy for the off-label use of Risperdal fueled by Biederman.
“Joseph Biederman: Pioneering pediatric psychiatrist and Harvard professor who set up a J&J funded center at Massachusetts General Hospital. The company hoped he would legitimize off-label Risperdal use.” -America’s Most Admired Lawbreaker
A New York Times article speculated the universities are incapable of policing their faculty’s conflicts of interest and the transgressions were “shaking the world of academic medicine and seems likely to force broad changes in the relationships between doctors and drug makers.”
As part of the 2010 Affordable Care Act, the Sunshine Act was passed in an attempt to increase transparency in the relationship between doctors and medical product manufacturers.
Yet eight years later, the New York Times released another investigative piece, co-written with ProPublica, showing not much has changed.
Prominent breast cancer doctor Dr. Jose Baselga, chief medical officer at Memorial Sloan Kettering Cancer Center in New York, resigned his position after it was revealed he failed to report millions of dollars in payments from pharmaceutical companies and medical device companies to the cancer center as well as The New England Journal of Medicine and The Lancet for dozens of research article he had published. Baselga earned $1.5 million a year for his work at Sloan Kettering, but received more than $3 million in consulting fees for Roche pharmaceuticals and his stake in a company Roche acquired.
According to The New York Times, “Dr. Baselga’s extensive corporate relationships — and his frequent failure to disclose them — illustrate how permeable the boundaries remain between academic research and industry, and how weakly reporting requirements are enforced by the medical journals and professional societies charged with policing them.”
In addition to lack of transparency and policing for conflicts of interest among researchers, peer review studies have multiple other flaws including overworked and underpaid reviewers, inconsistent reviews, and bias and spin.
“IT IS SIMPLY NO LONGER POSSIBLE TO BELIEVE MUCH OF THE CLINICAL RESEARCH THAT IS PUBLISHED.” -DR. MARCIA ANGELL, FORMER EDITOR OF THE NEW ENGLAND JOURNAL OF MEDICINE
Cancer Center’s Board Chairman Faults Top Doctor Over ‘Crossed Lines’, The New York Times, October 1, 2018
Researchers Fail to Reveal Full Drug Pay, The New York Times, June 8, 2008