Boston Globe: Medical group puts stop to talks on drug-firm ties

[Guest guest]

Boy oh boy! This never ends. Mulvey son

(http://www.boston.com/news/globe/)

Medical group puts stop to talks on drug-firm ties

Three Boston critics contend conflicts of interest need airing

Dr. Jerome Kassirer wrote " On the Take, " about doctors' conflicts.

(LISA POOLE/ASSOCIATED PRESS/FILE 2004)

(http://www.boston.com/news/globe/)

Medical group puts stop to talks on drug-firm ties

Three Boston critics contend conflicts of interest need airing

By Rowland, Globe Staff | December 27, 2006

The title of the proposed panel discussion cut straight to the point:

" Conflicts of Interest. " But attendees at the American Society of

Hypertension's

spring meeting in Chicago won't get to hear what panelists have to say about

financial ties between the drug industry and medical societies and physicians.

The society has rejected the session, saying it was " one-sided " and did not

meet " standards for fair balance and scientific rigor. "

Now, the cancellation itself is causing a conflict, prompting three

prominent drug industry critics from Boston who had been invited to participate

to

accuse the society of stifling debate.

" The society is hiding under a rock, " said Dr. Jerome Kassirer, a former

editor of the New England Journal of Medicine, who would have been a panelist.

The other two -- former New England Journal of Medicine editor Dr. Marcia

Angell and Dr. Jerry Avorn, a Brigham and Women's Hospital physician and

Harvard Medical School professor -- said they would have been unable to attend

the

conference. Angell said she had another commitment, and Avorn said he is

trying to cut down on speaking engagements. But both joined Kassirer in

questioning the society's decision to veto the session on conflicts of

interest, which

is a hot topic in the medical community.

" It's surprising that they would have taken such a drastic step as shutting

down a conversation about this, " Avorn said. " In principle, we should be

partaking in these discussions. We need more, not less of them. "

The episode is part of a continuing struggle within the American Society of

Hypertension over how industry money influences medical decisions, how much

financial disclosure should be required of prominent physicians, and whether

those disclosures should be broadly disseminated or kept private.

Other medical societies also are wrestling with such questions as they

increasingly rely on industry money to survive. Critics inside and outside the

organizations worry about commercial pressures and the loss of medical

independence.

The American Society of Hypertension represents about 2,400 cardiologists

and other physicians who research and provide care related to high blood

pressure. It sponsors medical meetings, distributes news about research

developments, and publishes two academic journals.

Angell, Avorn, and Kassirer were invited to take part in the panel about

conflicts of interest by E. Sealey, a researcher and former

president-elect

of the American Society of Hypertension. Sealey has said the drug industry

wields too much influence over the society's activities through its financial

contributions to the group and by paying for honoraria, speakers fees,

grants, and research contracts with individual doctors.

But the society's leadership alleged that Sealey had her own conflicts of

interest: While she served on the society's board, her husband, Dr. Laragh

, edited one of the society's academic journals.

Sealey agreed to give up her chance to be president, but was allowed to

organize a half-day session for next May's annual meeting.

Medical society meetings are typically forums for dozens of medical and

scientific panel discussions, presentations of trial results for new drugs, and

academic lectures. Many of the events are sponsored directly or indirectly by

drug companies. In a few cases, sessions on ethical issues are included, but

are largely eclipsed by medical and scientific topics.

The society's president, Dr. Suzanne Oparil , was unavailable for comment,

the society said through a public relations firm. The group said in a

statement that it sent Sealey's panel proposal to its continuing medical

education

review committee, which determined Sealey's plan to limit the panel to three

prominent drug industry critics lacked balance. It suggested adding a Food and

Drug Administration official to the roster, but Sealey refused.

In response to questions from the Globe, the society initially said in an

e-mail that fair balance is required under national standards for continuing

medical education programs, and that its internal continuing medical education

committee was compelled to reject the panel on those grounds. In a subsequent

e-mail, after Kassirer said there is no such requirement in the national

rules, the society said the expectation of fair balance is " inherent. "

Sealey said the purpose of her proposed panel was to provide a counterpoint

to the many industry sponsorships and payments to physicians who are

scheduled to present medical information at the meeting. At last year's

meeting, she

said, 100 of the 165 presenters disclosed financial ties to pharmaceutical

companies.

The society said it is trying to be more open about potential conflicts. Its

website lists 12 " corporate members " who provide financial sponsorship for

its programs, though the amount they donate is not disclosed. The society also

said it requires officers, board members, and lecturers to disclose

financial interests, including dollar ranges of compensation or grants. But not

all

of the information is made public. Dollar amounts are available only to

society members, who must sign a promise that they will keep the information

confidential.

Rowland can be reached at _crowland@..._

(mailto:crowland@...) .

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