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April 08, 2014

ProPublica Misses the Mark in Research Payments Article

The Boston Globe recently published a ProPublica-penned article which attacks doctors who speak about the drugs and antibiotics they have researched and helped develop. Entitled "Double Dip: Doctors Paid to Advise, Promote Drug Companies that Fund their Research," the articles states that "[m]ore than 1,300 practitioners nationwide received both research money and speaking or consulting fees from the same drug maker in 2012." The story provides little context behind these fees, and glosses over the often crucial relationship industry can have with physicians. Worse, Forbes reports that ProPublica completely missed the mark in lambasting infectious disease specialist Dr. Yoav Golan, the article's main target.

ProPublica frames the article around its Dollars for Docs database, which tracks what pharmaceutical companies spend on doctor speaking and consulting fees. ProPublica went through companies' public corporate integrity agreements and created a master database of the spend information. This article targeted research: "Research has been seen as less objectionable than other forms of interactions with drug companies, but 10 percent of researchers have multiple ties among the nine companies ProPublica analyzed," the article states. "That raises questions about doctors' impartiality."

And ProPublica is adept at posing questions. However, they rarely provide information sufficient enough for readers to come to informed conclusions. Forbes notes that the article "typifies a growing gotcha genre of health journalism that portrays doctors as the enemy in a struggle for honesty and openness in medicine." The articles struggle to show conflicts of interests, yet make "unfounded leaps" that will "end up doing patients a disservice."

Forbes contributor Ford Vox took most issue with ProPublica's focus on Dr. Golan, who works at Tufts Medical Center. "Yoav Golan is a remarkably bad choice for anyone who hopes to use him as a poster boy of pharma-physician malfeasance," Vox noted. According to Vox, not only did ProPublica have "little understanding [Golan's] contributions to medicine," but they misstated their facts. ProPublica pointed out that Merck paid Golan $12,050 in research payments. However, the money "went directly to Tufts for administrative expenses on a planned trial. Golan himself actually received no payments for the trial in that year."

Furthermore, ProPublica criticizes Tufts Medical Center:

"If Golan worked at some teaching hospitals, he would be barred or severely restricted from accepting both research funding and personal payments for promotional speaking or consulting from drug makers. These hospitals fear the money could influence clinical findings, or at least create the appearance of a conflict of interest. Yet Tufts and many other academic medical centers allow doctors to accept overlapping payments — and some doctors still take them."

ProPublica's "analysis" hinges on a simple comparison of Tufts with other universities. Vox noted: "That Tufts made a very considered decision to carefully navigate these funding sources means little to ProPublica since other top medical centers have decided differently, barring or heavily restricting the level of industry collaboration Tufts engages in. Yet the NIH encourages private industry collaboration." 

Indeed, the ProPublica article very well may chill the important advances doctors like Golan strive to discover.

Importance of Antibiotic Research

The Washington Post just published an article lamenting the fact that "antibiotics research industry has not kept up with the advancing state of antibiotic drug resistance."

Recognizing the need to stimulate investments in antibacterial drugs, Congress recently enacted the Generating Antibiotic Incentives Now (GAIN) to spur development of new antibiotics to combat the spread of antibiotic resistant bacteria. "Incentives for research and development and fast track FDA review are needed to stop these bacteria and infections from spreading," Senator Richard Blumenthal (D-CT) stated in a press release announcing the legislation. The GAIN Act will provides incentives to increase the commercial value of innovative antibiotic drugs and streamline the regulatory process so that pioneering infectious disease products can reach patients. "Incentives for research and development and fast track FDA review are needed to stop these bacteria and infections from spreading," Blumenthal asserted.

ProPublica takes the opposite approach

Vox notes that "[t]he past is riddled with clear cases of abuse, including companies that paid doctors generously as consultants when the doctors weren't actually contributing anything of value to the enterprise. That type of graft no longer exists in responsible pharmaceutical companies." He adds that he "certainly wouldn't focus a high profile media expose on anyone in particular unless [he] had clear evidence they've been corrupted."

Unfortunately, ProPublica's article focuses on a doctor who works within the rules of his institution, "which contain numerous safeguards and strong similarities to Pew's recommendations, which allow for industry funding of research and scientific consulting relationships, and recommend against 'promotional' speaking."

Hopefully the coming public release of industry transfers of value under the Physician Payments Sunshine Act doesn't trigger similar articles, which brush over the specifics of industry-physician relationship. We recently wrote about how industry can protect their physicians' reputations. In light of ProPublica's story, open communication between companies and their doctor-clients appears to be more important than ever.

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