The sick NIH LA Times 12/23

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December 23, 2004

EDITORIAL

The Sick NIH

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The Bush administration has just released a study by a 13-member federal

panel saying legalizing drug importation wouldn't really help lower prices and

might crimp research on new prescription drugs. Who would benefit from that

recommendation: consumers or U.S. pharmaceutical companies? Should we trust it?

If the rampant conflicts of interest at the National Institutes of Health

being reported by The Times' Willman are anything to go by, the answer is

a flat no.

As The Times first reported in December 2003, NIH doctors have pocketed

lavish fees and stock options from biomedical companies while keeping those

payments as veiled as possible.

In his latest installment, on Wednesday, Willman showed that the corrupting

links between the drug industry and the Bush administration were even more

pervasive than previously known. At least 530 government scientists at the NIH,

employees who are supposed to do independent research, have accepted fees,

stock or stock options in the last five years, often from companies whose

products the scientists evaluate.

Consider senior NIH psychiatric researcher Dr. P. Trey Sunderland III, who

pocketed $508,050 from Pfizer Inc. at the same time he worked with Pfizer in

his government capacity — and even endorsed one of its drugs. Or blood

transfusion expert Dr. Harvey G. Klein, who accepted $240,200 in fees and

$76,600 in

stock options from companies working on blood-related products. Or Dr. H.

Brewer Jr., who helped develop new federal cholesterol guidelines and

praised the cholesterol medication Crestor as he hauled in $31,000 from

Crestor's maker. Arcane rules at the NIH help keep many such connections

obscure.

Willman notes that Brewer, in a 2003 article in the American Journal of

Cardiology, minimized concerns about a muscle-wasting side effect of Crestor

—

effects serious enough that the consumer group Public Citizen called for the

drug to be banned.

The rationale for allowing this ethically bankrupt gravy train is that

without the extra income, medical researchers will shun government. Last month,

almost 200 NIH researchers preemptively complained that a ban on industry

consulting would make them " second-class citizens in the biomedical community. "

But employment by the NIH, one of the world's top research bodies, is itself a

privilege. The NIH may say it is worried about a brain drain, but far more

dangerous is the growing perception that it is a front organization for the

drug companies.

The problem at the NIH is not just that doctors aren't fully disclosing

their conflicts of interest. Even with full disclosure, substantial fees from

drug companies give researchers a mercenary reason to protect what amounts to a

business client. The same sorts of ties also trouble academic research, but

if government freely allows it, what can be expected of the universities?

With Congress in thrall to the drug industry lobby (how else could anyone

explain the lack of drug price negotiations in the costly Medicare prescription

drug " benefit " ?), what remains as a corrective is the weight of shame.

Unfortunately, it is a weight felt lightly by NIH Director Elias A. Zerhouni,

who

simply opposes an across-the-board ban. He is floating a bogus compromise

proposal, a one-year " moratorium " on consulting.

So what can be done? Zerhouni, unwilling or unable to control the appearance

of corruption in his midst, should step down. If an unassailable opponent of

the drug money trough at the NIH were then named by President Bush, with a

strong statement of support from him, we would have the beginning of an

answer.

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