The Sick NIH
The Bush administration has just released a study by a 13-member federal panel saying legalizing drug importation wouldn’t really help lower prices and might crimp research on new prescription drugs. Who would benefit from that recommendation: consumers or U.S. pharmaceutical companies? Should we trust it? If the rampant conflicts of interest at the National Institutes of Health being reported by The Times’ David Willman are anything to go by, the answer is a flat no.
As The Times first reported in December 2003, NIH doctors have pocketed lavish fees and stock options from biomedical companies while keeping those payments as veiled as possible.
In his latest installment, on Wednesday, Willman showed that the corrupting links between the drug industry and the Bush administration were even more pervasive than previously known. At least 530 government scientists at the NIH, employees who are supposed to do independent research, have accepted fees, stock or stock options in the last five years, often from companies whose products the scientists evaluate.
Consider senior NIH psychiatric researcher Dr. P. Trey Sunderland III, who pocketed $508,050 from Pfizer Inc. at the same time he worked with Pfizer in his government capacity -- and even endorsed one of its drugs. Or blood transfusion expert Dr. Harvey G. Klein, who accepted $240,200 in fees and $76,600 in stock options from companies working on blood-related products. Or Dr. H. Bryan Brewer Jr., who helped develop new federal cholesterol guidelines and praised the cholesterol medication Crestor as he hauled in $31,000 from Crestor’s maker. Arcane rules at the NIH help keep many such connections obscure.
Willman notes that Brewer, in a 2003 article in the American Journal of Cardiology, minimized concerns about a muscle-wasting side effect of Crestor -- effects serious enough that the consumer group Public Citizen called for the drug to be banned.
The rationale for allowing this ethically bankrupt gravy train is that without the extra income, medical researchers will shun government. Last month, almost 200 NIH researchers preemptively complained that a ban on industry consulting would make them “second-class citizens in the biomedical community.” But employment by the NIH, one of the world’s top research bodies, is itself a privilege. The NIH may say it is worried about a brain drain, but far more dangerous is the growing perception that it is a front organization for the drug companies.
The problem at the NIH is not just that doctors aren’t fully disclosing their conflicts of interest. Even with full disclosure, substantial fees from drug companies give researchers a mercenary reason to protect what amounts to a business client. The same sorts of ties also trouble academic research, but if government freely allows it, what can be expected of the universities?
With Congress in thrall to the drug industry lobby (how else could anyone explain the lack of drug price negotiations in the costly Medicare prescription drug “benefit”?), what remains as a corrective is the weight of shame. Unfortunately, it is a weight felt lightly by NIH Director Elias A. Zerhouni, who simply opposes an across-the-board ban. He is floating a bogus compromise proposal, a one-year “moratorium” on consulting.
So what can be done? Zerhouni, unwilling or unable to control the appearance of corruption in his midst, should step down. If an unassailable opponent of the drug money trough at the NIH were then named by President Bush, with a strong statement of support from him, we would have the beginning of an answer.