Primary Care Corner with Geoffrey Modest MD: Academic med centers & drug company boards

JAMA had an interesting/disturbing letter documenting extensive representation of Academic Medical Centers on the boards of the largest pharmaceutical companies (see doi:10.1001/jama.2013.284925 ).  47 of the largest 50 pharmaceutical companies in the world were evaluated based on 2012 data. Findings:

–40% of the drug companies had a least one board member who was in a leadership position at an Academic Medical Center.
–16 of the 17 US companies (94%) had at least one such board member.
–And, on reviewing the data provided in the article, Harvard/Partners/Mass General were quite well represented, being on 3 different boards and making    an average of about $320,000 for those individuals.  Unfortunately, the names of the specific individuals involved was withheld.

As I have mentioned before, there has been a fundamental shift in medical research over the past 30 years or so.  Prior to Ronald Reagan, the vast majority of research and publications in the refereed journals was funded by public money, such as the NIH.  Reagan cut back on funding for the public sector and promoted the private sector as the major funder, creating the current situation with the vast majority of articles in those journals are funded  by pharmaceuticals or medical device makers.  One issue that I noted in my review of the new AHA lipid guidelines, is that not only are the recommendations potentially tainted by scientists on the guideline committees receiving drug company money, but that even which studies performed are dictated largely by the drug companies (for example, a study trying to show the efficacy of ezetimibe by comparing it in combination with simvastatin versus placebo in patients with carotid artery disease, is a useless self-serving study and would only be funded by a drug company).  This JAMA article raises the stakes higher.  These are large amounts of money (average $312,564)  being given directly to the leadership of Academic Medical Centers to serve on the drug company board, which has direct fiduciary responsibility to shareholders to ensure the financial success of the company.

Paul Levy, former CEO of Beth Israel Hospital in Boston, wrote a blog also noting that this degree of complicity between the academic Medical Center’s and the drug companies is abhorrent, see here

geoff

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