In September 2018, Dr. José Balsega, chief medical officer of Memorial Sloan-Kettering Cancer Institute, ignominiously resigned from his position after a scandal engulfed the institution. In a searing article of ProPublica, which conducted the investigative reporting together with the New York Times, he was accused of clandestinely receiving millions from pharmaceutical companies and never reporting it in many scientific articles that he produced as first or secondary author.
Co-authors Charles Ornstein and Katie Thomas said: “ he has held board memberships or advisory roles with Roche and Bristol-Myers Squibb, among other corporations; he had a stake in start-ups testing cancer therapies; and played a key role in the development of breakthrough drugs that have revolutionized treatments for breast cancer…Balsega did not follow financial disclosure rules set by the American Association for Cancer Research when he was president of the group. He also left out payments he received from companies connected to cancer research in his articles published in the group’s journal, Cancer Discovery.” There are no rules for those who make them.
Considering that modern medicine, with its over-reliance in the biological model, has the capacity to sanction or condemn any new drug or treatment based on the opinion and data of the peer-reviewed medical journals, this lack of clarity in the disclosure of financial interests is very serious. For two decades there have been many honest professional efforts to police the rank and file. In April 2009 the Institute of Medicine (IOM) released a report where it recommends to “standardize the content format and procedures for disclosing financial relationships” and at the same time that these policies should be publicly available, preferably in the institution’s official website. In the past ten years, institutions and professionals have been grappling with this still searing issue.
In an article in Neurology Today, Dr. Corey Ford, professor of neurology and dean of research at the New Mexico School of Medicine said that: “a researcher may be required to only enroll patients in a study, but not to analyze the data or have any influence in the output portion.” With these institutional firewalls, the risk of a biased opinion of the whole process is greatly diminished. Another troublesome aspect is the channeling of companies’ payments directly to the researchers’ pockets in the form of the consulting fees, stipends for board memberships, speaking fees, etc. Dr. Kenneth Tyler, from the University of Colorado, said that all the outside activities of physicians must be channeled through the physician practice plan of the institution for a better oversight.
At the University of New Mexico there is a special institutional review board for senior officials above a certain level where all the major donations and gifts of private companies are scrutinized; moreover, all the outside collaborators in any program must fill the disclosure forms as well. The relationship of academia and the industry can be mutually beneficial as the latter can provide skills, technologies, scale and capital for bonafide initiatives that will serve the public at large. But it must be outlined in advance of any implementation in a way that is convenient for public access, rather than the often-cryptic institutional electronic disclosure systems. It must be cloud-based. There is still a long way to go before there is a truly honest, accurate and straightforward exposé of all the significant medical data in our society.
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