Here’s something little known outside of the small circle of industry marketers, academic docs, PR flacks, and medical journalists: pharmaceutical and device companies (or their PR agencies) regularly offer to arrange interviews with well-known academic physicians to talk about new trials, drug approvals, and other items of obvious interest to the companies involved.
I receive these sort of invitations all the time. Here’s a redacted version of a recent email I received:
Hi Larry:
More than [VERY BIG NUMBER] Americans suffer from [COMMON DISEASE] and it is one of the few cardiovascular diseases on the rise. A new study, published online today by [FAMOUS JOURNAL], reveals there are gaps in the quality of [COMMON DISEASE] care provided to thousands of patients by cardiologists who don’t always follow guidelines for patient treatment.
As featured in [FAMOUS NEWSPAPER], the [BIG STUDY] is the largest [STUDY OF ITS TYPE] …
Would you be interested in learning more about the existing gaps in [COMMON DISEASE] patient care… Please let me know what you think and I could help arrange the following interviews:
Expert Interview:[FAMOUS CARDIOLOGIST], M.D., Professor of Cardiovascular Medicine at [FAMOUS UNIVERSITY] and [FAMOUS STUDY NAME] study lead is available to provide a detailed analysis of the new study and the potential… to improve… patient care, which will ultimately reduce hospitalizations and save lives….
Sincerely,
[PR PERSON]
It almost seems too obvious to ask, but should independent academic physicians allow themselves to be dangled like live bait in front of journalists hungry for an easy interview? Of course, I’m not privy to the arrangements between the doctors and the companies, but it’s pretty clear that these doctors are either receiving substantial fees for their promotional work or the appearances are considered to be standard duties of investigators in company-sponsored trials. In either case, these “independent” doctors are reduced to cogs in the promotional machine.
Let me be clear: physicians should be free to comment on trials and other medical news events. But they shouldn’t be paid to do so by industry, and their comments should be based on the best interests of their patients, not the companies paying for their research.
In recent years I’ve made a point of refusing these offerings, but it’s surely the case that many journalists, on deadline and without much knowledge of a complex field, may find this sort of spoon-fed journalism quite enticing.
Here’s another example:
Larry,
I wanted to offer one of the lead researchers on [DRUG A] as a resource as this [DRUG B]-rival seeks final FDA approval …. [FAMOUS DOCTOR NAME] has led several pivotal studies related to [DRUG A] that were presented at AHA Scientific Sessions and ESC Congresses.
He can offer a clear perspective on how [DRUG A] will transform the way cardiac patients are treated, provide details on potential side effects and risks and talk about how the new drug may affect [DRUG COMPANY]‘s financial performance in the near future. More details on[FAMOUS DOCTOR NAME]’s research is below. Please call [PHONE NUMBER] or email me if you’d like to speak to [FAMOUS DOCTOR NAME].
Thanks,
[PR PERSON]
In addition to the same questions raised by the previous letter, the obvious question to ask here is whether physician leaders should be thinking about, much less discussing and pumping, the “financial performance” of the companies for whom they perform clinical trials? But perhaps it was always about business anyway.
Larry,
I agree it is inappropriate. It goes beyond web based marketing. Drug Company sponsored dinners are still around. Academics see these as a way to supplement their salaries.
Beyond that, and further below the radar is the practice of drug companies performing statistical analysis on data that is then provided to the “investigator”. I have heard comments that “the Company” will even write the manuscript for you.
Something is broken.
Good stuff Larry. Keep it up!
Of course patients are the losers in all this, Larry. Increased drug company costs (due to marketing and PR budgets), and time taken away from patient care and research. If patients weren’t involved, and weren’t the vulnerable “species” in all this, it would hardly matter (for example, if it was a bunch of really esteemed engineers or architects who were being parried in front of journalists). I say let the data be interpreted by evidence-based physicians without the need for so much spin, hype, and marketing. On the other hand, I fully understand the need for big pharma to recoup the billion dollar plus costs of bringing 1 in 10,000 candidate molecular species to the stage of approval and marketing. The market is the only way to encourage pharmaceutical innovation (unfortunately).
Thanks, Dan. Just to be clear: I am NOT opposed to companies marketing and promoting their products. That’s their job. But I am completely opposed to physicians who care for patients or who teach other physicians having any involvement in that marketing and promotion.
Just got an email to the press from NEJM as well. They provide the contact information for these physicians as well. The NEJM wants to promote those reprint requests! 40% of the revenue at Lancet comes from reprint requests. NEJM refuses to disclose the amount of their revenue that is generated in this fashion.
There is nothing wrong with the NEJM helping to connect the authors of NEJM papers with the media. This is done to help reporters develop a complete story by asking questions of the authors. The authors have an obvious interest in defending or explaining their trial, but they are not compromised simply by doing so. In fact, I strongly encourage all scientists to explain and discuss their work with the rest of the world.
It appears that you only post comments that are favorable to you and the NEJM. I think this demonstrates a lack of journalistic integrity.
Chill out, dude! This is just a part time hobby for me, and occasionally I have other things to do with my life. In any case, as you can see, I am happy to post your all too hasty comments.
What % of NEJM revenues are from the sale of reprints? What % of NEJM revenues are from the sale of reprints to pharma companies for distribution by sales or medical affairs departments? Please call for the public disclosure of this information.
Thanks for highlighting the ethical responsibilities of physicians and other researchers.
I get the flood of pitches like the ones you displayed, too… and just reflexively trash them. But I hadn’t given much thought to this specific type of compromise made by health & medical professionals who allow their time & reputations to be used as marketing tools.
One more reason for journalists to ask in EVERY interview about the relationship between experts and companies/products and potential conflicts of interest.
“…I am completely opposed to physicians who care for patients or who teach other physicians having any involvement in that marketing and promotion.”
Larry, the system would need an enormous overhaul to align with this viewpoint, akin to Prohibition in 1920’s for alcohol. Which party is going to take the lead on this? FDA? NIH? HHS? AMA? State licensing authorities?
And who is going to police the PhD scientists (who are not MD’s) who would still be allowed to participate in pharma marketing exercises?
As Bill Clinton might have said (or likely did in fact say), “I feel your pain [Larry].”