A new study shows that Thompson is far from alone.
Nearly 1 of every 10 board positions at health-care companies is held by an academic-affiliated person, ranging from medical school deans to hospital heads to professors, according to an analysis of 2013 data published in the British Medical Journal on Tuesday.
In an age where even relatively small, one-time payments from pharmaceutical companies to doctors have come under intense scrutiny because they may skew prescribing practices or research, the study reveals that some of the most well-paid and influential leaders in medicine are sitting on the boards of publicly traded health-care companies, where they are richly compensated.
“These people who are on boards are among the most famous, the most sought-after academics in the country. At the same time, they are making very large incomes, based on their positions, so what they’re doing is simply padding their incomes, with a lot of extra money,” said Jerome Kassirer, editor in chief emeritus of the New England Journal of Medicine. “I think it’s a bad idea, and I think it’s widespread.”
For years, it’s been known that academics served on drug company boards, but the new study chronicled just how prevalent and remunerative these relationships are throughout the health-care industry. The board members received $193,000, on average, and owned more than 50,000 shares of stock. The study found 279 academically affiliated leaders on the boards of 442 companies – including 17 chief executives of health systems, 11 vice presidents or executive officers, 15 university leaders, and eight medical school deans or presidents. Collectively, they received $55 million in compensation and owned nearly 60 million shares of stock.
“Part of the impetus for this is it’s remarkable that my $15 lunch with a pharmaceutical company is on a public Web site, if this information is not. It is publicly available, but you have to do a lot of searching and connecting,” said Walid Gellad, an associate professor of medicine at the University of Pittsburgh School of Medicine, who led the study.
A spokeswoman for Memorial Sloan Kettering said Thompson was out of town giving talks and could not be reached but that his outside activities are reviewed and evaluated by the cancer center’s board – including his board membership with Merck and another company for which he received more than half a million last year, Charles River Laboratories International.
“Although trained as a physician, he does not see patients and does not participate in clinical research or the decisions about which therapeutic agents are included in the hospital formulary,” said Avice Meehan, a spokeswoman for Memorial Sloan Kettering.
The study did not show that these conflicting positions led any professor, hospital chief executive or medical school dean to make choices in the interest of a company they worked for on the side. In fact, the study refrained from even naming any individuals at all. Gellad said that was because his team sought instead to map the scope of potential influence that exists at the very highest levels of academic medicine and not to limit the attention to a single case. Among medical schools that receive taxpayer money from the National Institutes of Health, 19 of the top 20 best-funded schools had a leader, professor or trustee represented on a company’s board.
Some argue that these relationships can benefit medical schools and hospitals, especially as they increasingly attempt to work more closely with the industry to bridge the “valley of death” – the gap between basic research and commercial products and drugs.
“Some people will look at this as a good thing, that there’s this kind of interaction between industry and academia,” Gellad said. “We’re talking so much about conflict of interest – let’s talk about all of it, and let’s not leave out a certain part because it involves certain people we don’t like to talk about.”
Kassirer argues that disclosure is not enough, but many medical schools have policies in place to avoid conflicts of interest that tend to lean heavily on disclosure and transparency.
For example, Vanderbilt University Medical Center has had a policy in place since 2009 that requires such relationships to be reviewed by a committee. Gordon Bernard is Vanderbilt’s associate vice chancellor of research and chair of the Pharmaceutical and Therapeutic Use Committee, which makes decisions about the formulary, the approved list of drugs the hospital uses. He is also on the board of directors of Cumberland Pharmaceuticals.
“These activities were long ago institutionally vetted and approved. Dr. Bernard recuses himself from any institutional matters where there could be a potential conflict of interest,” said John Howser, assistant vice chancellor for news and communications.
Cumberland’s proxy statement, however, particularly mentions Bernard’s expertise in this regard as an asset: “The Board believes Dr. Bernard’s medical background is extremely valuable as the Company seeks to continue expanding its pipeline with promising products that offer advancement to patient care and are well-positioned competitively.”