Healthy Skepticism Library item: 7601

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Publication type: news

Timmerman L.
Cancer Group Requires Doctors to Disclose All Ties
Bloomberg.com 2007 Jan 19
http://www.bloomberg.com/apps/news?pid=20601087&sid=a1KDaw3ey3mo&refer=home

Abstract:

Cancer doctors must disclose all financial ties to investment firms, said a leading U.S. physician group seeking to stop the leak of insider information on clinical drug trials.

The American Society of Clinical Oncology described the new policy, the most strict of any medical group, in a Jan. 20 article in the Journal of Clinical Oncology. The Alexandria, Virginia-based professional organization has more than 23,000 members worldwide.

Cancer physicians must disclose all consulting or advisory arrangements they have with either investment or commercial interests, the policy says. Investment firms cultivate doctors with lucrative consulting arrangements, and traders can use their inside knowledge to buy and sell stocks of companies developing new therapies before the information becomes public.

``We want to caution our members that they could get in some trouble by doing this,’‘ said Allen Lichter, 60, chief executive officer of the group, in a telephone interview. ``This is not just innocent conversation.’‘

The committee of authors said in the journal article the new policy was necessary to make sure a physician’s main motivation was advancing the science for drug trial sponsors, academic institutions and patients who volunteer for clinical testing.

``Many oncologists are involved in critically important clinical research,’‘ the authors wrote. ``Maintaining public trust is essential to achieving enrollment in this research, and ultimately, developing new therapies.’‘

Applies to All

Lichter said the disclosure applies to all members who publish research in the Journal of Clinical Oncology and give public speeches at the group’s medical meetings. The policy is effective immediately, he said.

``We’re saying to our members that they should not do this, so hopefully there will not be a whole lot to disclose,’‘ Lichter said.

The policy was crafted in response to reports about the growing practice of physicians consulting for Wall Street firms about confidential drug research, typically for $300 to $500 an hour, the authors wrote. The practice was described in an August 2005 investigative report by The Seattle Times, and it later attracted scrutiny from Senator Charles Grassley, Republican of Iowa, and the U.S. Securities and Exchange Commission.

The Times found 26 cases in which doctors leaked critical information about ongoing drug research to investment firms, despite signing confidentiality contracts with sponsors of drug trials.

Risky Relationships

``This is an excellent initiative,’‘ said Steven Nissen, president of the American College of Cardiology and chairman of cardiovascular medicine at the Cleveland Clinic in Ohio.

``Relationships between physician-scientists and investment companies are inherently risky, and should be disclosed,’‘ Nissen said. ``I would support this approach for all medical journals and continuing education activities.’‘

Two leading medical journals, the New England Journal of Medicine and the Lancet, have editorialized against doctors consulting for Wall Street, and the Association of American Medical Colleges warned all U.S. medical schools that their faculty should ``scrupulously honor’‘ their confidentiality agreements while conducting drug research.

Nissen said he would suggest a similar measure to the editor of the Journal of the American College of Cardiology.

Stopped Consulting

Peter Eisenberg, a prominent cancer physician in Marin County, California, said the newly strengthened ethics policy for cancer doctors was a ``necessary step.’‘ He said the advice will help physicians who want to do the right thing, yet, ``for those who aren’t scrupulous, no policy will suffice.’‘

Eisenberg said he stopped his $600 an hour consulting with Wall Street firms after reading the Seattle Times report about how investors elicit inside information from doctors. The Jan. 20 journal article cited instances where analysts have posed as fellow doctors or patients in order to elicit information from doctors.

``They know how to get the information, and basically, I don’t know how to keep it to myself, so I decided to stop,’‘ Eisenberg said of working with investment firms.

Difficult to Stop

Sheldon Krimsky, a professor at Tufts University in Medford, Massachusetts, who has studied academic conflict of interest for 25 years, said medical societies are afraid their members could be charged with insider trading. He said that while the policy appears to take the practice seriously, it may not be effective.

``The financial benefits to elite investment companies are high, and it will be difficult to stop this practice and monitor the effects of the policy recommendation,’‘ Krimsky wrote in an e-mail message today.

Lichter said there was ``broad enthusiasm’‘ for the tough new policy within the organization’s leadership; he’s unsure whether members will resist the new requirements as overly intrusive.

Lichter said cancer doctors need to be especially aware of conflicts of interest because they typically have close relationships with pharmaceutical and biotech companies developing new therapies, and therefore have ``more exposure’‘ to dealings with investors.