JAMA writers call for medical groups to sever financial ties to industry

A group of distinguished medical leaders have called on professional medical associations (PMAs) to radically alter their relationship with industry. The Special Communication appeared in JAMA and was co-authored by a diverse group of writers, including first author David Rothman, of the Institute on Medicine as a Profession at Columbia University, JAMA editor Catherine DeAngelis, former ACC president Steve Nissen, and the past or current presidents or CEOs of the American Academy of Pediatrics, the American Psychiatric Association, and the American College of Physicians.

One key proposal is that “PMAs should work toward a complete ban on pharmaceutical and medical device industry funding ($0), except for income from journal advertising and exhibit hall fees.”

Since PMAs can not sever all their financial ties to industry immediately, they recommend a number of interim measures, including:

All funds from industry should be truly unrestricted—given for the purpose of supporting the mission of the PMA. The donated funds should be pooled and administered by each PMA through a central repository.

Each PMA might establish a CME committee whose members, free of all industry ties, would have the responsibility to distribute unrestricted, educational grants from industry. This committee would have exclusive authority to select program topics and speakers; industry would not be allowed to fund or be identified with specific lectures or individuals.

PMAs should not endorse, facilitate, or accept funding for satellite symposia. This may be accomplished by not allowing satellite symposia to take place immediately before, during, or immediately after the conference, by not sharing the names and addresses of members, and not sharing conference space. To enforce this policy, PMAs may ban a company that violates these rules from exhibiting at future meetings.”

CardioBrief received the following comment from Sanjay Kaul (we invite additional comments from our readers):

The editorialist’s manifesto is a laudable attempt at addressing concerns and plugging loopholes at various appropriate levels including corporate strategy and equity interests of the medical industry and conflict of interests of professional societies. I couldn’t agree more with their proposed remedial measures. However, I am particularly struck by one statement “Accordingly, PMAs should work toward a complete ban on pharmaceutical and medical device industry funding ($0), except for income from journal advertising and exhibit hall fees”. Advertising and commercial involvements have arguably tainted the ethical status and editorial independence of these professional medical associations, especially their journals, damaging their credibility and respectability. These activities rather belie the ‘infomercial’ underpinning of professional societies’ alliance with the very entity (corporate sponsors) they seek to distance themselves from.

If professional medical associations are to finally take the bold step in expunging all the conflicts, they should sever all ties with the industry including a complete ban on “pharmaceutical and medical device industry advertising and exhibit hall fees”. Only by setting up such an example will they have truly earned the right to be seen as playing an important role in speaking for medicine, defining best practices, and promoting evidence-based decision making in an objective, unbiased, and uninfluenced manner and without undermining the public’s trust.

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