Pharmaceutical company payments to doctors extend far beyond
rank-and-file clinicians — and deep into the leadership of America’s
teaching hospitals, according to a study published today in the Journal of the
American Medical Association.
A team of researchers at the University of Pittsburgh Medical
Center examined the boards of the 50 largest drug companies by global sales (excluding
three companies that were not publicly traded). The researchers found that 40
percent — 19 companies — had at least one board member who also
held a leadership role at an academic medical center. Sixteen of the 17
companies based in the United States had at least one. Several had more than
one.
All told, the research team found that 41 of the companies’ 2012
board members held leadership positions at academic medical centers. Six of the
41 were pharmaceutical company executives who served on hospital boards of
directors or held other leadership posts.
Excluding the industry executives, the academics earned an
average of nearly $313,000 that year for their board service.
ProPublica
has been chronicling conflicts of interest in medicine for several years by
looking at drug makers’ payments to individual medical practitioners for
consulting, speaking and more. Our Dollars
for Docs database currently collects information on payments by 15
companies that publicly report them, most as a condition of lawsuit settlements
with the federal government.
Beginning this fall, under a provision of the 2010
Affordable Care Act, all pharmaceutical and medical device companies will have to publicly report payments to
physicians. The first report is expected to be released in September
and will cover payments made from August to December 2013.
In the study published today, the authors wrote that when academic
medical leaders serve on pharmaceutical company boards, it can lead to conflicts
not only for individuals, but for the critically important health care
institutions they guide.
As board members of drug companies, academic leaders take on
a fiduciary duty to those companies’ success. That can “conflict or compete”
with their other responsibilities, the study says.
“Given the
magnitude of competing priorities between academic institutions and
pharmaceutical companies, dual leadership roles cannot simply be managed by
internal disclosure,” the authors conclude. “These relationships present
potentially far-reaching consequences beyond those created when individual
physicians consult with industry or receive gifts.”
Among the academic leaders serving as drug-company board
members was the dean of the University of Illinois College of Medicine, whose institution
was criticized recently when members of its surgery department
appeared in an ad for the daVinci surgical robot.
