Medical school dean talks industry-relations policy

Jan. 4, 2011, 3:04 a.m.

An investigation by nonprofit news outlet ProPublica found in December that several faculty members at the Stanford School of Medicine gave paid talks on behalf of drug companies, violating University policy and spurring the School of Medicine to decide whether to take disciplinary action.

The investigation included a database by ProPublica listing doctors who have accepted payments from any of several pharmaceutical companies, the amounts of these payments, and the companies that made them.

Philip Pizzo, dean of the School of Medicine, condemned these violations in his weekly newsletter to the Stanford medical community.

“There have been a lot of prior communications about the policies at Stanford and many stories in the lay and medical press about the problems associated with physicians serving in marketing roles,” Pizzo wrote. “This is unacceptable, certainly for anyone with a Stanford title.”

Stanford has cracked down on faculty-industry contact. In October 2006, the University implemented the Stanford Industry Interactions Policy, which forbids faculty from accepting gifts or compensation from industry and required them to disclose all financial support they received for research or other “continuing medical education.” In 2009, Stanford banned its doctors from giving paid promotional talks for any pharmaceutical company.

Despite recent violations, Pizzo believes the policy and its addenda have, for the most part, been effective.

“While I would very much like 100 percent compliance at the outset, I am mindful that it will take a little time to get there,” Pizzo wrote in an e-mail to The Daily. “The fact that over 1,200 faculty are compliant and that we believe about four to six have not been (out of entire faculty group) is something to frame positively…going forward we do very much expect full compliance with the policies and I am optimistic that will happen.”

ProPublica’s online database cites seven companies that made payments to doctors: AstraZeneca, Cephalon, Eli Lilly, GlaxoSmithKlein, Johnson & Johnson, Merck and Pfizer. The majority of infractions stemmed from faculty receiving “speakers’ fees” — monetary compensation for speaking on behalf of a particular pharmaceutical company.

According to Robert Malenka, professor in psychiatry and behavioral sciences, the reaction within his circle of colleagues to the policies has been mixed.

“There’s a way of implementing policies where you prevent inappropriate influences of the pharmaceutical industry on clinician decision-making while still facilitating other types of interactions which benefit both academic research centers and the long-term goal of the pharmaceutical companies, which is to make new and better medications,” Malenka said.

In his newsletter to the School of Medicine, Pizzo also cited positive interactions with the industry as integral to the University’s success and credibility as a research institution.

“It is time to reaffirm a commitment, individually and collectively, to assuring the public trust in our relations with industry,” Pizzo wrote. “We are eager to support productive and valuable scientific interactions with industry as long as they do not involve marketing, are fully disclosed and adhere to our policies.”

The School of Medicine will strictly enforce the policy and its addenda, Pizzo said.

“If true violations have occurred, we will pursue appropriate disciplinary activity,” Pizzo wrote in his e-mail. “That process is underway and something I can’t comment on further at this time.”

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