When is writing a memo fun? When the sender is you, the recipient is you, and its purpose is to authorize payment – to you.  We’re pretty sure Dr. Charles Nemeroff enjoyed getting that memo (from himself) authorizing $3000 to be paid (to himself) for writing a medical journal supplement, as much as we would enjoy a similar return-address windfall.

But what about that journal supplement itself? These ‘special sections’ in medical journals – often sponsored and usually focused around a related topic, like a disease group or drug class – tend to be less editorially rigorous, amounting to nothing more than glossy chances for companies to buy extra ad space.  In this Journal of the American Medical Association study, blinded reviewers found that the quality of the medical articles – in study design, sample size, and analysis — was inferior in the supplements to those published in the parent journals. And other scholars and clinicians have wondered openly whether they are worth the paper they’re printed on – much less $3000.

Yet, that self-payment was just one of the more trifling findings of the Senate Finance Committee into the large undeclared industry payments to Dr. Charles Nemeroff, former head (and by former, we mean Friday) of the Emory University Department of Psychiatry and principal investigator on an NIH grant to study a GlaxoSmithKline drug there. And by industry payments, we mean GlaxoSmithKline.

While the Committee has been hot on the trail of 30 academic psychiatrists and their disclosure sheets that don’t match up to company records, the case around Dr. Nemeroff – depicted in this letter from Committee Chair Sen. Charles Grassley to Emory and obtained by Pharmalot — is singular in the repeating and bald-faced quality to Nemeroff’s bucking of the NIH rules, which require universities to ‘manage’ conflicts caused by investigators’ significant conflicts of interest (defined as $10,000 per year).

For instance, in August 2004, Nemeroff wrote to Emory’s conflict-of-interest committee to say he was in compliance with the $10,000 limit — and in that month alone Nemeroff took in excess of that yearly maximum in speaking gigs and “non-product” phone calls alone.

After Emory’s COI committee raised questions about his failure to follow approval protocol of his consulting agreements and discrepancies on his disclosure sheets, Nemeroff wrote another memo, this one not as fun, about his future compliance, which read: “I will follow the management plans for my conflicts of interest”… and “I shall limit my consulting to GSK to under $10,000/year and I have informed GSK of this policy.”

Grassley’s letter goes on:

Barely a week after this promise, on July 12, 2004, GSK paid Dr. Nemeroff $3,500 in fees and $505.40 in expenses for a talk he gave regarding Paxil at the Larkspur Restaurant and Grill in Las Vegas, Nevada. The following day, Dr. Nemeroff gave two more talks in exchange for $7,000 from GSK ($3,500 per talk).

Maybe the maxim, What happens in Vegas, stays in Vegas, just hasn’t made it to the Beltway yet.