WebMD, Eli Lilly and a quiz about depression
Filed under: Conflicts of interest, Health journalism
Sen. Chuck Grassley, the prolific writer of public letters who often assumes the mantle of health consumer advocate, is at it again. This time he’s taking on consumer health information giant WebMD, whose ties with Eli Lilly seem to stretch back for some time. At issue is a WebMD quiz that purported to determine a user’s risk of depression. The fishy part? Until WebMD modified the quiz following Grassley’s letter and other outcry, even users who answered “no” to every question would be given the warning that “You may be at risk for major depression.”
As Daniel Carlat points out on his blog, the following disclaimer appeared at the top of the page: “This content is selected and controlled by WebMD’s editorial staff and is funded by Lilly USA.” As Carlat points out, 9 of the 10 symptoms in the quiz are taken from standard diagnostic criteria, but the one that isn’t (which relates to physical pain) just happens to dovetail perfectly with the pain-relief market Lilly is trying to carve out for Cymbalta.
Because Lilly markets Cymbalta as the “go to” antidepressant for patients who have both depression and physical pain. This is not really a “depression screening test” at all. Instead, it is a “Cymbalta-requester” screening test.
WebMD is telling the public a big lie. The say that “this content is selected and controlled by WebMD’s editorial staff” when in fact the crucial aches and pains questions was selected by Eli Lilly’s marketing team to encourage patients to ask their doctors for Cymbalta.
Grassley’s letter requested that WebMD respond with the details of their relationship to Eil Lilly by March 4. I didn’t find any evidence that such a response has yet been received.
Reporter finds conflict in N.Y. reform effort
Filed under: Conflicts of interest, Health care reform
A Syracuse University professor charged with reforming health insurance reimbursements gave up her position on an insurance company’s board on Friday after James T. Mulder, a reporter with The (Syracuse, N.Y.) Post-Standard, started looking into her ties.
Deborah Freund, a health economist and professor at Syracuse University, is overseeing a project intended to reform the health insurance system and eliminate conflicts of interest.
However, she has been on the board of Excellus since 2004 and received more than $61,000 from the health insurance company last year.
Freund oversees “FAIR Health Inc., a New York City-based nonprofit that is supposed to come up with a new, fair reimbursement system that will be used by insurers nationwide.” The project is funded by settlements from 13 insurers that used reimbursement data that rigged the system “to benefit insurers at the expense of consumers and doctors.”
At a news conference last year, [state Attorney General Andrew] Cuomo said the FAIR Health project will bring “ … transparency, accountability and fairness to a broken reimbursement system …”
Despite earlier statements from Excellus, the university and Cuomo’s office that Freund’s board position did not post a conflict of interest, a view not shared by consumer advocates, the professor resigned from the board Friday afternoon after Mulder spend several days looking into the situation.
Rule limits Harvard docs’ conflicts of interest
Harvard doctors will now be limited to making $5,000 a year for serving as board members for drugmakers and biotech companies, under a new rule intended to reduce the conflicts of interest in medical research.
Scott Hensley explains and rounds up the coverage on NPR’s Shots blog, with links to stories in The New York Times and The Boston Globe. Hensley writes that the new rules also prohibit taking company shares as compensation and from serving on drug companies’ speaker bureaus.
MIWatch.org calls for real disclosure reform
Filed under: Conflicts of interest, Pharmaceuticals, Studies
Phyllis Vine at MIWatch.org, a site that follows news about mental illness, asks whether drug company disclosures about payments made to doctors go far enough and whether anyone actually pays attention to such disclosures.
Vine raises the question of doctors taking part in “educational settings, including grand rounds, courses at professional conferences, or continuing education programs that pharma spends billions of dollars underwriting.”
She addresses the disproportionate number of psychiatrists who represent pharmaceutical companies and dominate the upper bracket of paid speakers. Vine also notes that, while many schools have drafted or are drafting policies about faculty-industry relations, enforcement of those policies is questionable.
Read the whole post on MIWatch.org.
Covering Health: First year’s most popular posts
With a year of posts behind us, we thought it would be a good time to look back and see what posts proved to be the most popular – or at least the most read:
- Lewin group linked to private insurers
- Autism news raises question: When is an embargo not an embargo?
- Hensley joins NPR’s expanding health team
- Report: $25,000 buys access to Post’s health reporters
- CDC monitors H1N1 swine flu-human reassortment
- Oransky to take helm at Reuters Health
- Top N.Y. neurosurgeons suspended, sued
- Pharma industry still finding its way in social media
- Hospital says it gives content to short-staffed media
- Kuklo scandal spotlights DoD/Medtronic ties
- ‘Playing through’ concussions is damaging
- Where to find the facts on health care reform
- CBS questions CDC’s H1N1 prevalence estimates
- VA officials seize reporter’s audio recording
- Oprah’s health advice needs a shot in the arm
- Autism and vaccines: A failure to communicate
- Will pharmacists play a role in H1N1 vaccinations?
- Covering Obama’s stance on stem cell research
- Appleby to report for Kaiser Health News
- Prevention vs. treatment in global health
- FDA staff calls for end to corruption, wrongdoing
- Mentally ill patients, elderly mix in nursing homes
- Three health-care issues Obama, Congress will face
- Jost discusses consumer-driven health plans
- Tim Tebow’s head fuels concussion debate
Wis. researchers didn’t disclose conflicts to journals
Filed under: Conflicts of interest, Hot Health Headline
Milwaukee Journal Sentinel reporter John Fauber reports that conflicts of interest that local researchers disclosed to the university were not always disclosed when those researchers’ work was published.
Their investigation, a “spot check” of about 40 researchers, uncovered at least nine conflicts, such as the cancer specialist (bio) at the University of Wisconsin who “co-authored a medical article on TomoTherapy, a radiation therapy system developed by researchers at the university.” The article failed to mention that the physician had disclosed the university that he’d make $20,000 in 2008 consulting for TomoTherapy, and that he owned TomoTherapy stock options.
Fauber explores the causes of these failures to disclose conflicts of interest, which include systemic weaknesses in both research and publication and reliance on an “honor system.” He talks a little about his reporting method; it’s the sort of story that can be localized by anyone whose local university has a conflict of interest disclosure policy.
Med school conflict of interest policies rated
Filed under: Hot Health Headline, Pharmaceuticals, Studies, Tools
The American Medical Student Association released a 2009 version of their PharmFreeScorecard, evaluating 149 U.S. medical schools based on their stated conflict-of-interest policies. According to the executive summary, 21 percent of schools improved their policies in the last year, with 16 more schools scoring an A or B in 2009.
AMSA rates policies in fields such as scholarships, continuing medical education, purchasing, gifts and samples, curriculum, consulting, speaking and disclosure and combines them to determine a school’s overall grade. The association handed out 9 As, 36 Bs, 18 Cs, 17 Ds and 35Fs, with 27 schools still pending or otherwise in the process of changing their regulations.
Reports: Clinical trial oversight lacking
Filed under: Conflicts of interest, Hot Health Headline
ProPublica’s Alexandra Andrews reviewed two recent reports on conflicts of interest in the institutional review boards tasked with overseeing clinical trials and found that these boards may not be as independent as the public might like.
Board members “frequently” had connections with drug companies that can cause conflicts of interest, and while IRB chairs said they’d never presided over a session in which a conflicted member had voted, only 65 percent of surveyed members said they recused themselves every time a conflict came up. One third of surveyed IRB’s don’t even require members to disclose conflicts of interest, Andrews reported.
Sen. Chuck Grassley (R-IA), who has been a prominent advocate for the disclosure of doctor-industry ties, told ProPublica, “People have to trust that decisions about clinical trials are unbiased, and this study calls that into question. Lack of disclosure of financial ties can damage confidence in important medical research. Disclosure policies ought to be established and enforced to safeguard the integrity of that research because of its tremendous influence on the practice of medicine and public health.”
Even more alarming was a recent GAO release detailing the lack of barriers to the creation of for-profit IRBs.
GAO investigators created phony IRBs [7] (PDF), which they were successfully able to register with HHS using no more than an online registration form. One such company listed its address as “1234 Phulovit Lane” in “Chetesville, AZ” with employees named “April Phuls, Timothy Wittless, (and) Alan Ruse.” (You can still find its deactivated listing [8] on HHS’s Web site.)
Subsequent oversight wasn’t any better.
HHS then approved an assurance [9] for a bogus medical device company, also created by GAO, which listed one of GAO’s fake IRBs on its application. An assurance basically promises that the company will adhere to federal standards and, once approved, paves the way for that company to request federal research funds. According to GAO, “By approving our assurance application, HHS essentially deemed our bogus IRB as adequate to oversee human subjects research.”
And it almost sounds like some actual IRB’s weren’t much better than the one run by April Phuls and Alan Ruse.
GAO’s pièce de résistance was a sting operation involving real IRBs. GAO’s medical device company sent out plans for a fake trial to three real IRBs. Two of them responded with cries of “awful,” “a piece of junk” and the “riskiest thing I’ve ever seen on this board.” But the third IRB, now identified as Colorado-based Coast IRB, found it “probably pretty safe” and voted unanimously to approve it.
In HHS’ defense, at a hearing, Jerry Menikoff, director of the Office for Human Research Protections, which oversees IRBs along with the Food and Drug Administration, said “by registering an IRB, the government, the federal government is in no way endorsing that IRB or in any way saying that that IRB meets any standards.”
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
