I’ve made mention in these pages numerous times of the dubious practice of medical researchers being on the payrolls of the pharmaceutical industry. I’ve known about these shady alliances for my entire career, but what I didn’t know was just how lucrative they were for the researchers involved. This past weekend both the Wall Street Journal and the New York Times reported on drug company payments to a prominent Emory University psychiatrist and researcher and former editor of the journal Neuropsychopharmacology.
Senator Charles Grassley (R. Iowa) is probing into this mess because any federally-funded research is supposed to free of financial conflicts of interest. Enforcement of these rules is usually left to the universities employing the researchers, which are apparently easily flim flammed by the researchers involved. In the specific case reported by both papers, the Emory researcher Dr. Charles Nemeroff, was instructed by Emory not to take more than $10,000 per year from GlaxoSmithKline, the drug company for whom he was doing research on their bestselling antidepressant drug Paxil. But despite his assurances to Emory that his income from Glaxo was within the limits, Dr. Nemeroff’s take was just a little more.
From 2000 through 2006, Dr. Nemeroff received just over $960,000 from Glaxo, but reported to Emory that he received no more than $35,000.
Though the $960,000 payment by Glaxo is a king’s ransom, it may be only the tip of the iceberg. Apparently Dr. Nemeroff was on the payroll of a number of other drug companies as well.
In a June 2004 Emory report obtained by Sen. Grassley, the school concluded Dr. Nemeroff had committed violations of its conflict-of-interest policies. At the time, he had consulting arrangements with about a dozen companies, including Merck & Co., Bristol-Meyers Squibb Co. and Eli Lilly & Co.
And don’t think this behavior is an aberration limited to this one physician. Many, many more are on the teat of the pharmaceutical industry. From the New York Times article:
Mr. Grassley began his investigation in the spring by questioning Dr. Melissa P. DelBello of the University of Cincinnati after The New York Times reported her connections to drug makers. Dr. DelBello told university officials that she earned about $100,000 from 2005 to 2007 from eight drug makers, but AstraZeneca alone paid her $238,000 during the period, Mr. Grassley found.
Then in early June, the senator reported to Congress that Dr. Joseph Biederman, a renowned child psychiatrist at Harvard Medical School, and a colleague, Dr. Timothy E. Wilens, had reported to university officials earning several hundred thousand dollars each in consulting fees from drug makers from 2000 to 2007, when in fact they had earned at least $1.6 million each.
Then the senator focused on Dr. Alan F. Schatzberg of Stanford, president-elect of the American Psychiatric Association, whose $4.8 million in stock holdings in a drug development company raised concerns.
What do these researchers do to get paid this kind of money? They promote the companies’ drugs. The Wall Street Journal gives us a glimpse of what goes on.
On March 19, 2004, the senator [Sen. Grassley] said, Dr. Nemeroff addressed questions from Emory’s Conflicts of Interest Committee in a letter in which he wrote: “Apart from speaking at national symposia, such as the American Psychiatric Association, for which GSK might serve as a sponsor, my consultation to the company is limited to chairing their Paroxetine Advisory board and for that, I am remunerated $15,000 per year.” Paroxetine is the chemical name for Paxil.
Just three days earlier, however, Glaxo paid Dr. Nemeroff $3,500 for a talk he gave on Paxil in Orlando, Fla., Sen. Grassley alleges.
The next day, March 17, he gave another $3,500 talk about Paxil in Kissimmee, Fla. In the week after writing to the conflict-of-interest committee, Dr. Nemeroff gave three talks on Paxil, for $3,500 each, at various locations in New York, according to the senator.
On July 6, 2004, Dr. Nemeroff promised the university he would limit his consulting work to Glaxo to under $10,000 a year, according to Sen. Grassley. But a week later, in two days of work, he exceeded that limit, according to records provided by the senator. He said that on July 12, 2004, GSK paid Dr. Nemeroff $3,500 in fees and $505.40 in expenses for a talk he gave on Paxil in Las Vegas; and that he was paid $7,000 for two talks he gave for Glaxo the next day.
In an Aug. 4, 2004, letter to a university dean, Dr. Nemeroff said he had “taken the necessary steps to be in compliance with the recommendations” of the Emory conflicts panel, “namely my consulting fees from GSK will be less than $10,000 per year throughout the period of this NIH grant, its renewals and final collections of data.” He said Glaxo had been informed of the step and was supportive.
But according to Glaxo records, Dr. Nemeroff exceeded the $10,000 limit that month.
It’s apparent that Dr. Nemeroff got a fair amount of his money from giving talks to doctors about Paxil. Given the circumstances, I doubt that he was discouraging its use.
I don’t know why Sen. Grassley is so hell bent on rooting out financial improprieties in the world of antidepressant research when those drugs account for only a fraction of the sales that statins do. Although I haven’t seen reports in the major media, I would assume that these kinds of violations are rampant among statin researchers since there is many multiples of the money available there as opposed to that available for promotion of psychiatric drugs.
Although I can’t find the actual quote, I think it was George Bernard Shaw who said “I find it hard to trust a man who tells me my gall bladder needs removing when he stands to make £300 for removing it.” I, myself, find it hard to trust a man who tells me I my patients need to take Paxil when he stands to make $960,000 for telling me so. Multiply that sentiment by a factor of at least 10, and that will tell you how much I trust a man who tells me I need to take a statin.