With financial ties to nearly two dozen drug and biotech companies, Dr. Charles B. Nemeroff may hold some sort of record among academic clinicians for the most conflicts of interest. A psychiatrist, a prominent researcher, and chairman of the department of psychiatry and behavioral science at Emory University in Atlanta, Nemeroff receives funding for his academic research from Eli Lilly, AstraZeneca, Pfizer, Wyeth-Ayerst–indeed from virtually every pharmaceutical house that manufactures a drug to treat mental illness.
He also serves as a consultant to drug and biotech companies, owns their stocks, and is a member of several speakers’ bureaus, delivering talks–for a fee–to other physicians on behalf of the companies’ products. But it was just three of Nemeroff’s many financial entanglements that caught the eye of Dr. Bernard J. Carroll last spring while reading a paper by the Emory doctor in the prominent scientific journal, Nature Neuroscience. In that article, Nemeroff and a co-author reviewed roughly two dozen experimental treatments for psychiatric disorders, opining that some of the new treatments were disappointing, while others showed great promise in relieving symptoms. What struck Carroll, a psychiatrist in Carmel, Calif., was that three of the experimental treatments praised in the article were ones that Nemeroff stood to profit from–including a transdermal patch for the drug lithium, for which Nemeroff holds the patent.…How did we get to this point? What effect is industry influence having on the treatment of patients? And why are the medical journals not more vigilant to weed out papers that have been distorted by conflict of interest? The answers to these questions begin, oddly enough, with an amendment to U.S. patent law called the Bayh-Dole Act. Passed in 1980, Bayh-Dole for the first time permitted universities to commercialize products and inventions without losing their federal research funding, the seed money for innovative research. The brainchild of George Keyworth II, President Reagan’s science advisor, who was watching the United States get beaten in world markets by the Japanese, Bayh-Dole was intended to stimulate advanced technological invention and speed its transfer from university labs into private industry, where it could be put to work spurring U.S. productivity.It seemed like a win-win proposition. Indeed, Bayh-Dole has helped launch the biotech industry and has propelled several life-saving products to market. The basic research behind Gleevec, for instance, an incredibly effective new anti-cancer drug, was done by a university scientist. The drug’s manufacturer, Novartis, stepped in and provided additional funding for development. In 1984, private companies contributed a mere $26 million to university research budgets. By 2000, they were ponying up $2.3 billion, an increase of 9,000 percent that provided much needed funds to universities at a time when the cost of doing medical research was skyrocketing.
That’s the upside. The downside is that Bayh-Dole has also fostered increasingly cozy relationships between the academics upon whom the nation depends for unbiased medical information and Big Pharma, private companies whose main goal, let’s face it, is making a profit. And we’re talking serious money here. In addition to the salaries built into company-sponsored research grants, academic clinicians at medical schools can pad their already decent incomes with $1,000-a-day consulting contracts with pharmaceutical companies, patent royalties, licensing fees, and big-payoff stock options. Nemeroff stood to reap as much as $1 million in stock from a company that manufactured one of the products in his Nature Neuroscience paper. At many of the top research universities and medical schools around the country, a substantial percentage of the faculty enjoys the perks of industry relationships. At MIT, 31 percent of the science and engineering faculty has outside income; at Stanford Medical School, it’s 20 percent…
But it was already an old story for me. In the mid-1970’s, I decided to change medical specialties – from Internal Medicine to Psychiatry. The details aren’t important, but the change had to do with things inside of me, not external events. So, in 1974 I came to Atlanta and started training in Psychiatry and Psychoanalysis. By the mid-1980’s, I was directing the residency training program in Psychiatry and finishing my analytic training. Then we got a new Chairman, and the focus of the Department changed radically. Psychotherapy and psychoanalysis were "out" and "medical psychiatry" was "in." I lasted a year or so, then left the Department and went into practice. I continued teaching in the Psychoanalytic Institute, but wasn’t otherwise associated with the Department. The new Chairman was short-lived, moving on to become the Dean of the medical school, a position he now holds at another Institution. His replacement was Charles Nemeroff, one of the Dean’s former colleagues.
To be honest, I didn’t know exactly what had happened. Suddenly, everything in Psychiatry was about drug research and I was a dinosaur in my early forties. But, there was more than enough work in my chosen area, and I adapted to my new life as a practicing physician in the community. But over the years, I heard about the Department as it flourished as a center of biological research. I wasn’t particularly sympathetic to all these changes. It was as if the thing that had drawn me to change specialties a decade earlier had been pushed to the back burner, and replaced by a medication factory. I couldn’t really tell if my negativity about all of this was personal or scientific – but I suspected [and still suspect] it was both.
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So when I read that Dr. Nemeroff has finally been "busted," and that it began ", oddly enough, with an amendment to U.S. patent law called the Bayh-Dole Act. Passed in 1980, Bayh-Dole for the first time permitted universities to commercialize products and inventions without losing their federal research funding, the seed money for innovative research. The brainchild of George Keyworth II, President Reagan’s science advisor, who was watching the United States get beaten in world markets by the Japanese, Bayh-Dole was intended to stimulate advanced technological invention and speed its transfer from university labs into private industry, where it could be put to work spurring U.S. productivity", it felt exactly like my all my political concerns for the last thirty years.
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It felt exactly like I feel when I read about the systematic dismantling of Glass-Stegall Act of 1933 via the Depository Institutions Deregulation and Monetary Control Act of 1980, the 1982 Garn-St. Germain Depository Institutions Act , the 1999 Gramm-Leach-Bliley Financial Services Modernization Act, and the Commodity Futures Modernization Act of 2000 allowing the credit default swaps that set up the conditions for today’s Stock Market Crash.
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And it’s exactly how I’ve felt about Bush’s Wars and Bush’s and Cheney’s systematic deconstruction of our Constitution. The issues that this blog has been about from the start.
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