The Association of Clinical Researchers and Educators, a group convened to defend unregulated industry-physician relationships and fight a growing movement to limit the influence of marketing on medicine, held its charter meeting on the campus of Brigham and Women’s Hospital in Boston yesterday.
While some of the conference was an opportunity for academic physicians like ACRE director Thomas Stossel MD to rail against “a belief system” that has made key opinion leaders, speakers bureaus, and ghostwriting into “meaningless demonic slogans,” much of the daylong agenda was devoted to promoting stuff we believe, too: namely, the importance of academic-industry collaboration in the development and approval of new drugs. Case studies in the accelerated research into multiple myeloma and pediatric cancers illustrated the good that can come from industry and academic physicians working together on legitimate, necessary research — research that won’t be hampered by current state gift and disclosure laws, or by federal transparency proposals like the Physician Payments Sunshine Act (S.301).
Though conference presenters expressed everything from concern to outright mockery at Massachusetts’ gifts and disclosure law, attorneys there to discuss what the law means for physicians reminded the audience that much of the Massachusetts gift ban was just the codification of the industry’s own voluntary codes, and thus shouldn’t represent a sea change in conduct. Regulators’ and lawmakers’ care to protect innovation, research, and clinical trial conduct in the state went unmentioned.
Several speakers chastised the industry for being silent on its own behalf (though in reality, both AdvaMed and PhRMA have come out in support of a federal transparency law). Accusing the media of blood thirst and bias was another common refrain.
“Attacking [academic medical centers] is like attacking girl scouts,” said Thomas Fogarty MD, director of the Fogarty Institute, who spoke about the importance of collaboration in drug innovation.
“Nobody is holding the press accountable for the harm they have done,” said J. Michael Gonzalez-Campoy MD, an endocrinologist from Minnesota and a board member of the American Association of Clinical Endocrinologists, the one medical professional society that threw its support behind ACRE. “My patients are being harmed by biased reporting,” he said.
Many speakers criticized their own profession’s efforts to become more transparent about conflicts of interest, including recent recommendations from the Institute of Medicine and the Association of American Medical Colleges (AAMC) that call for greater disclosure and limits to industry gifting and involvement in medical education.
Some also decried conflict-of-interest policies that individual AMCs have developed.
“The really sleazy stuff in medicine has come out of academic institutions,” said Avi Markowitz MD of the University of Texas-Medical Branch at Galveston, whose own policies limiting drug company marketing on campus received an “A” on the American Medical Student Association’s PharmFree Scorecard. Policies like these “are being handed down from deans and administrators in academic medicine who have no financial needs, and don’t live in the real world,” Markowitz said.
Toward the end of the meeting, the presenters seemed to engage in an informal horse-race about their financial disclosure listed in the program. Michael Weber, a professor from SUNY Downstate Medical Center College of Medicine, began his talk this way: “My disclosures are in the booklet, and I’m proud to say my list is longer than anyone else’s.” But when Fogarty got up to the podium, he said he thought he probably had Weber’s list beat.
“I am so conflicted I’ve become un-conflicted,” he said.