Posted by When I was in medical school it was common to get gifts from drug companies. Since many of us had very little money, the gifts were welcome. One company gave me a Littman stethoscope, at the time, the most advanced stethoscope around. The same model costs about $100 now. I was glad to get it, although I can’t tell you the name of the company. I forgot the names as quickly as I pocketed their gifts. We all got lots of free samples, too, and they were often things like tranquilizers sent through the mail and left in the magazine bin in my apartment house common mailbox area. Yes, these folks were trying to get me to prescribe their drugs but in those days (more than 40 years ago) they were doing it in a fairly ham handed and straightforward way. My father was a GP and he kept a huge rack of samples he gave free to his patients, many of whom couldn’t pay his $2 office visit bill, much less buy prescription drugs. That was then. In recent decades drug companies have gotten very, very sophisticated. Yesterday’s New York Times has a contemporary example from Harvard Medical School:
In a first-year pharmacology class at Harvard Medical School, Matt Zerden grew wary as the professor promoted the benefits of cholesterol drugs and seemed to belittle a student who asked about side effects.
Mr. Zerden later discovered something by searching online that he began sharing with his classmates. The professor was not only a full-time member of the Harvard Medical faculty, but a paid consultant to 10 drug companies, including five makers of cholesterol treatments.
?I felt really violated,? Mr. Zerden, now a fourth-year student, recently recalled. ?Here we have 160 open minds trying to learn the basics in a protected space, and the information he was giving wasn?t as pure as I think it should be.?
Mr. Zerden?s minor stir four years ago has lately grown into a full-blown movement by more than 200 Harvard Medical School students and sympathetic faculty, intent on exposing and curtailing the industry influence in their classrooms and laboratories, as well as in Harvard?s 17 affiliated teaching hospitals and institutes. (Duff Wilson, New York Times)
Agitation by medical students on this issue is not new. There were vigorous movements in the 60s, 70s and 80s. Meanwhile Big Pharma and the biotech industry has busily infiltrated medical school faculties to the point where rooting them out will be a difficult job. In the current economic environment scientists look for support wherever they can find it. As a long time researcher with a successful funding record I don’t take any industry money, but I understand the impulse to do so and I have many colleagues who do, sometimes to save or advance a research program dear to their hearts and sometimes to save their jobs and sometimes because they are greedy bastards who want the money and often combinations of all of these reasons.
Harvard, like many prestigious universities, has avidly and whorishly accepted huge gifts from chemical companies like Monsanto to do research to cure the very cancers Monsanto’s products may have caused. I know many scientists who do science with Monsanto or Merck or Squibb or some other big company. Some of them are world class scientists who would never fudge data or alter findings to suit their paymaster. But Monsanto would never ask them to. That’s not how the game is played. Monsanto (or whoever) gets two important things out of their arrangement. They get advanced notice and first crack at important discoveries in basic and applied science, giving them what is often a crucial head start over competitors. And just as importantly for a company like Monsanto, by affecting the research agenda itself, they direct what is a scarce resource, productive scientists and their laboratories, toward science that benefits them and away from science that might hurt them.
As for individual faculty members, the situation at Harvard is completely out of control:
But no one disputes that many individual Harvard Medical faculty members receive tens or even hundreds of thousands of dollars a year through industry consulting and speaking fees. Under the school?s disclosure rules, about 1,600 of 8,900 professors and lecturers have reported to the dean that they or a family member had a financial interest in a business related to their teaching, research or clinical care. The reports show 149 with financial ties to Pfizer and 130 with Merck.
The new Harvard Medical School Dean has his own history:
Dr. Flier, who became dean 17 months ago, previously received a $500,000 research grant from Bristol-Myers Squibb. He also consulted for three Cambridge biotechnology companies, but says that those relationships have ended and that he has accepted no new industry affiliations.
Compared to the previous Dean, though, he’s squeaky clean:
That is in contrast to his predecessor as dean, Dr. Joseph B. Martin. Harvard?s rules allowed Dr. Martin to sit on the board of the medical products company Baxter International for 5 of the 10 years he led the medical school, supplementing his university salary with up to $197,000 a year from Baxter, according to company filings.
Dr. Martin is still on the medical faculty and is founder and co-chairman of the Harvard NeuroDiscovery Center, which researches degenerative diseases, and actively solicits industry money to do so. Dr. Martin declined any comment.
Harvard will undoubtedly clean up some of its act. But the Big Pharma/biotech/chemical company cancer has metastasized very widely in American medical education and academic science. More government support of research and stricter conflict of interest rules will help but won’t cure the disease. Research supported by drug and chemical companies has done some real good, but also much damage and it is costly in many ways. The results are privatized, licensed and profits exorbitant.
And it’s not at all clear there is a net benefit.
March 4, 2009
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