Financial COIs Identified in British Medical Journal
Researchers writing in the British Medical Journal in 2020 followed the “money trail” of several prominent PMAs and found their leaders received significant drug maker largesse between 2017 and 2019.“Leaders of the North American Spine Society received more than $9.5 million for general payments,” the researchers wrote. Orthopaedic Trauma Association (OTA) leaders received more than $4.7 million during the time period. Michael McKee, president of the OTA, responded to the research article by saying most of that funding was for research. Other PMA leaders took money for similar reasons.
“Research payments linked to leaders of the American Society of Clinical Oncology were over $54 million and for those of the American College of Cardiology, almost $21 million,” the BMJ study noted.
Is Heart Association’s Food Certification Program a Conflict?
Almost everyone is familiar with the 108-year-old American Heart Association (AHA) and its public health messaging. Yet fewer people know that the organization is paid by food manufacturers to put a “heart-check” mark on hundreds of foods that reads “American Heart Association Certified: Meets criteria for heart-healthy food.”Questions About Diabetes Associations
According to its website, the Juvenile Diabetes Research Foundation (JDRF) is funded by many corporations including drug makers Abbott, Lilly Diabetes, and Novo Nordisk who are “Platinum Partners” contributing between $1 million and $2.5 million annually. The Access to Medicine Foundation calls Lilly Diabetes and Novo Nordisk two of the world’s top three insulin makers (The third is Sanofi.) Since insulin is basic to diabetes care and prohibitively costly, some have asked why JDFR and the American Diabetes Association (ADA) haven’t been more aggressive in protesting the high price of insulin on behalf of patients.“Living with this illness is a precarious existence. As people with T1D [Type 1 diabetes], we have traveled to other countries to get cheaper versions of the drug and have been forced by insurance companies to use lower-quality insulin,” they wrote. “Many people with diabetes meet in parking lots to exchange supplies or starve themselves to lower the amount of insulin they need.”
Twenty-five percent of insulin-dependent diabetics “ration insulin, which can lead to complications including life-threatening diabetic ketoacidosis, blindness, amputation, and death,” Annalisa van den Bergh and Robin Cressman wrote.
The authors weren’t entirely pleased with diabetes nonprofits and recent U.S. national legislation.
“Major diabetes nonprofits have supported incremental measures but have remained silent on more meaningful reform,” they wrote.
“Copay caps tie our survival to the health care status quo because anyone is at risk of losing their insurance, allow the big three to continue to profit from $300 a vial insulin, and in our view give the false impression that the problem is being solved.”
The ADA didn’t respond to The Epoch Times’ request for comment about its insulin pricing efforts. Meanwhile, the JDRF told The Epoch Times it has long advocated for the lowering of out-of-pocket insulin costs for people with diabetes.
“This includes our recent multimillion-dollar investment in the Civica insulin project that will provide three of the most frequently prescribed insulins for $30 per vial and $55 for a box of five pens, regardless of insurance status. We have also spent years lobbying Congress and calling on insulin manufacturers, health plans, employers, and the government to take action to lower the cost of insulin. These efforts have led to the recent $35 monthly cap on insulin costs for Medicare enrollees,” the JDRF said.
“These companies have no role in decisions about advocacy and research priorities. Most of our funding comes from those affected by Type 1 diabetes, who raise funds from their friends, families, and professional contacts through our Walk, Gala, Ride, and other fundraising programs,” the JDRF responded.
Concerns About Association COIs Aren’t New
More than 10 years ago, concerns about pharmaceutical funding influencing policy guidelines and clinicians were already surfacing. Researchers wrote in the journal Annals of Family Medicine that “there has been dramatic increase in the diagnosis and pharmaceutical management of common chronic illnesses.” After conducting a study of Type 2 diabetes and hypertension treatment in 44 primary care clinics in Michigan, they recommended “limiting the influence of the pharmaceutical industry on clinical practice, toward improving the well-being of patients with chronic illness.”“In 2009, the American Geriatrics Society joined others in advocating for greater opioid use to treat chronic pain in seniors, especially those 75 and older,” the newspaper reported. “The new guidelines recommended that over-the-counter pain relievers, such as ibuprofen and naproxen, be used rarely and that doctors instead consider prescribing opioids for all patients with moderate to severe pain. The group’s guidelines are a key reference for thousands of doctors on the front line of medicine.”
Other Medical Associations Respond
The Epoch Times asked the North American Spine Society to comment on the BMJ’s characterization of its industry funding, and Jeff Karzen, senior manager of publications at the society, said he had no comment.Dr. James Kirkpatrick, chair of the American College of Cardiology [ACC] Ethics and Compliance Committee, spoke to The Epoch Times about the figures identified in the BMJ article.
“The ACC itself collaborates with industry, including in the administration of unrestricted, multi-company financial support, In doing so, we follow the highest standards of oversight, transparent structure, and unbiased management.
“It is worth noting that, in the BMJ study, more than 90 percent of payments made to ACC leaders was in the form of research support, which is categorically different than direct payments to physicians and other transfers of value, as it is usually administered through a third party, such as a medical school, research institute, or granting agency.”
The American Society of Clinical Oncology (ASCO) also emphasized research support when responding to The Epoch Times’ request for comment.
“As referenced by the BMJ article, the majority of financial relationships with healthcare companies were related to research and paid directly to academic institutions,” the ASCO said. “This research serves an important role in clinical oncology and is critical to making progress against cancer through improved treatments that advance cancer care for patients.”
On its website, the society states, “ASCO regards the management of potential conflicts of interest as paramount to the integrity of ASCO’s programs, products, and services.”