Tag Archives: COI

Australia lagging in conflict-of-interest disclosures

When a country is holding up the United States as a model of progress on medical conflict of interest issues, you might suspect there are some serious systemic issues there. Such seems to be the case in Australia, based on Melissa Sweet’s recent post on the Croakey blog. At present, there’s little baseline research into industry funding and influence in Australia, though what little there is seems to indicate a situation similar to what we’ve found in the United States. The lack of research seems to stem from a lack of awareness and perhaps even indifference.

ozPhoto by acediscovery via Flickr

The catalyst for this post seems to be the Walkey Media Conference, a media industry confab sponsored by the national journalists’ union that generated a bit of controversy thanks to a sponsorship from Exxon Mobil.

Sweet found a University of Sydney seminar in July that was to look at conflicts of interest to be less than packed, and inferred that Aussie “academics seem to regard (COI) as irrelevant, tedious or confronting.” Furthermore, she wrote, “Australian universities are dragging the chain in dealing with their staff’s conflicts of interest, at least compared with institutions in the US.”

The post makes a strong, well-researched case for COI disclosure and serves as a sort of roundabout compliment to the dogged American journalists (we’re looking at you, John Fauber) who are creating mainstream awareness of conflicts of interest.

(Hat tip to Gary Schwitzer)

Most EU patient groups get industry money

Over at Pharmalot, Covering Health veteran Ed Silverman reports on one European activist group’s survey of corporate sponsorship and disclosure in patient and consumer groups across that continent. The report focuses on the 23 groups eligible to work with the European Medicines Agency, an agency responsible for the scientific evaluation of medicines developed for use in the European Union. The EMA has clear transparency guidelines, but this report gives a strong indication that they’re often neither followed nor enforced.

euPhoto by dimnikolov via Flickr

HAI [the advocacy group] notes the EMA introduced transparency guidelines in 2005, but by March 2010, 20 of the 23 eligible groups that were surveyed had not yet reported 2006 income online. “Despite the lack of compliance, all organizations were invited to participate in the EMA annual meeting in December 2009,” HAI adds. One problem cited: EMA guidelines do not stipulate a reporting deadline or cycle, and so some groups have not yet met requirements established five years ago.

Here’s a summary of the data:

  • Fifteen organizations were either partly or almost entirely funded by industry-related groups, only seven had fully independent funding. One was unknown.
  • Contributions went up over the three years examined in the study. From Silverman: “The average donation rose from 185,500 EUR (about $235,500) per sponsored organization in 2006, to 282,090 EUR (about $358,00) in 2007, and to 321,230 EUR in 2008 (about $407,800). In percentage terms, the increases amounted to 47 percent, 51 percent and 57 percent, respectively (please note the dollar figures are expressed in today’s values).”
  • Most groups didn’t follow EMA transparency guidelines. Only six seem to have complied with the full letter and spirit of the rules.

The full report is available here (20-page PDF). If you’re just looking for the juicy stuff, scroll to the results table on page 10.


For more news about health care and news coverage in Europe, be sure to visit AHCJ’s new Covering Europe pages.

AAMC gives recommendations for clinical COI

After taking on continuing medical education and medical research, the Association of American Medical Colleges is now tackling conflicts of interest related to clinical care with its latest report, “In the Interest of Patients: Recommendations for Physician Financial Relationships and Clinical Decision Making” (46-page PDF). If you’re just looking for the Big Recommendations, the most salient of which are paraphrased below, fast forward to pages 24 and 25. Warning: They’re vague.

  • Medical centers should compensate doctors in a way that promotes the patients’ best interests.
  • Professional medical societies and medical institutions (such as teaching hospitals) need to take a long, hard look at their own relationships with the industry.
  • Institutions should identify their physicians’ industry relationships, set thresholds for their disclosure, and identify situations in which disclosures should be made directly to the patient. These regulations should all have teeth.
  • Centers and physicians should work with patients to figure out how best to disclose industry ties.

The AAMC committee that produced the report wrote that, while they focused on academic medicine, their recommendations could (and should) be applied to all of clinical medicine.

J-S settles records suit; docs rebel against COI rules

As a result of the Milwaukee Journal Sentinel‘s now-settled lawsuit against the University of Wisconsin, John Fauber was able to review newly public e-mails which show just how angry a segment of the faculty became when faced with the university’s new, stricter conflict of interest regulations. The regulations came, of course, in the wake of Fauber’s investigative reporting on the subject.

The newspaper’s lawsuit argued that the faculty comments were public records under Wisconsin law and sought a court order to obtain them. To settle the lawsuit, the newspaper agreed to accept the 41 e-mails with the names of the doctors blacked out. The foundation also provided a separate list with the names of the 28 doctors who wrote the e-mails.

The (UW Medical Foundation) also agreed to pay the newspaper’s attorneys’ fees of about $12,400.

The e-mails make for good reading, and Fauber wastes no time in deploying the liveliest phrases in his story.

For example, some physicians complained about the 18-month exemption for orthopedic surgeons and other implanters of medical devices, including one who said “Allowing our docs to shill for device companies is a complete perversion.” An orthopedic surgeon responded with a different take, saying it was “clearly ridiculous” to limit his hourly take from device makers to just $500.

For an explanation from Fauber on how he has been able to consistently produce groundbreaking stories on the conflict-of-interest beat, see the article he wrote for AHCJ.

APA’s new policy seeks collaboration with pharma

The Wall Street Journal‘s Shirley Wang looked beyond the American Psychiatric Association’s new conflict of interest guidelines to explore what the APA’s loosening of ties with major pharmaceutical manufacturers meant for their business model and future. The APA has lost 10 percent of its revenue – about $7.5 million – over the past year as pharma is spending less on advertising in their journals and sponsored symposia have been phased out of the APA annual meeting. That last move, Wang found, cost the organization about $2 million.

In an interesting twist, Wang says that while some of the decline in pharma advertising can be attributed to the recession and APA’s attention to COI, some of it comes “because the industry faces its own pressures to avoid potential conflicts of interest.” Overall, pharma’s ad spending in health care publications has slipped from $865 million in 2005 to $626 million in 2009.

Reactions to these tightening regulations and budgets among APA membership has been mixed, as Wang illustrates:

At the annual conference in 2008 in Washington, D.C., Dr. Scully recalled meeting a group of young residents and medical students at the bottom of an escalator who wanted to “express their outrage” at the industry influence at the meeting. At the top of the escalator ride, he encountered another group of doctors upset that there weren’t enough seats in the industry-sponsored symposia. “A number of members liked those [symposia] and they liked that they got fed,” said Dr. Scully.

In an accompanying blog post, Wang writes that the APA hopes its new guidelines will increase transparency, decrease conflict and still maintain a good, cooperative relationship with the pharmaceutical industry.


COI policy change has medical associations talking