Although new conflict-of-interest rules have been written for physicians and other health experts who sit on the panels that issue the U.S. government’s major medical guidelines, many panel members continue to have such conflicts, reports the New York Times.
A major reason is that the members of some of those panels — most notably, ones that will be issuing guidelines next year on high blood pressure (hypertension), cholesterol and obesity — were appointed before the new conflict-of-interest rules went into effect.
Such conflicts, of course, only contribute to the public’s distrust of the government’s health recommendations.
Writes Times reporter Duff Wilson:
[S]ome experts say the panels — while less conflicted than their predecessors — are still too close to the drug industry. At least eight members of the obesity panel, seven on the cholesterol panel and five on the hypertension panel are taking money in various forms from companies that could profit from their recommendations. The money ranges from small travel reimbursements to more than $400,000 for years of research.
“Consciously or not, they may well be making decisions that fit their funders, their payers and not the patient’s best interests,” said David J. Rothman, president of the Institute on Medicine as a Profession, a nonprofit center affiliated with Columbia University. “If you want the public to really believe in the guidelines, why not have a committee that is conflict-free?”
“Recusing, disclosing — the reason it doesn’t work is the process involves give-and-take,” said Dr. Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, who has written about guideline panels. “Even if you don’t make a formal vote, you can still have a huge influence over what happens in the process.”
Following the money
What, specifically, are those conflicts? The National Institutes of Health would not release the conflict-of-interest statements of the members of the hypertension, cholesterol and obesity panels to the Times. The government agency claimed that doing so would be an invasion of those members’ privacy and would interfere with the panels’ work. Wilson’s own research, however, turned up the following conflicts:
At least eight of the 19 members of the obesity panel have financial ties to a phalanx of private business interests, records show. GlaxoSmithKline, maker of Alli, an over-the-counter product, has made payments to four of them. Four have financial ties to Allergan, maker of the Lap-Band stomach device. One is paid to speak or advise 11 companies with obesity products. And others consult for companies like Nestlé or Weight Watchers. [The co-chair of the panel, who herself, according to Wilson, has received payment from at least eight companies with financial interest in the panel’s final recommendations, disputed — but wouldn’t clarify — the precise number of conflicts uncovered by the Times.]
The cholesterol panel includes seven professors with financial ties to drug makers, six without conflicts and three government experts, records indicate. …
Five of 17 members of the hypertension group have taken money from drug makers since it formed in 2008.
An increasing problem
It is possible to convene government medical panels free of corporate conflicts of interest. As the Times article points out, the 16 members of the U.S. Preventive Services Task Force that recommended against routine prostate screening last month had no financial conflicts that would have prevented any of them from voting.
But, as the Times also points out, with government funding for medical research on the decline — and with private industry funding on the rise — finding individual researchers without any financial conflicts of interest may become increasingly difficult.
You can read the Times article on the newspaper’s website. (Remember: If you aren’t a subscriber, clicking on the link will count toward your monthly allotment of free articles.)