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Group asks US National Institutes of Health to reveal industry ties

BMJ 2007; 334 doi: http://dx.doi.org/10.1136/bmj.39097.388218.DB (Published 18 January 2007) Cite this as: BMJ 2007;334:115
  1. Janice Hopkins Tanne
  1. 1New York

    The US Center for Science in the Public Interest is calling on organisations and researchers to sign a letter asking the US National Institutes of Health (NIH) to reveal ties to industry among scientists on its advisory committees. The centre's “integrity in science” project is starting by targeting speakers at a national conference next month on screening for neonatal herpes.

    The centre is asking organisations and researchers to sign a letter protesting at the fact that four of the five speakers at the NIH conference on 20 February have undisclosed ties to companies that make antiviral drugs to treat herpes.

    The draft letter, which was shown to the BMJ by a US scientist, is addressed to Elias Zerhouni, director of the NIH, and to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, Carolyn Deal, chief of that institute's sexually transmitted infections branch, and Walla Dempsey, clinical trials programme officer at the institute. Copies will be sent to the chairmen of the health related committees in the House of Representatives and the Senate.

    Merrill Goozner, director of the integrity in science project, said that the letter was still being finalised and that he could not say how many people or organisations had signed it.

    He said that the issue was important because doctors are encouraged to follow evidence based guidelines on clinical practice, “but who writes the evidence [based guidelines]?”

    The centre's draft letter calls on the NIH to “adopt the standard long in place at the Office of Medical Applications of Research [OMAR] inside the Office of the NIH director.”

    It continues, “It is our understanding that OMAR prohibits physician-scientists with conflicts of interest from serving on its consensus panels.”

    The NIH conference will make recommendations about screening pregnant women for their risk of transmitting herpes infection to their babies. Treatment might involve the use of drugs to prevent neonatal infection, such as GlaxoSmithKline's valaciclovir (Valtrex).

    The draft letter says that neonatal herpes is rare and that worries about transmission are “highly contentious.” The letter mentions a front page story in the Wall Street Journal (13 Dec 2006, p A1) reporting that GlaxoSmithKline had paid doctors for speaking engagements and continuing medical education sessions promoting the screening of all pregnant women for herpes. The article said that more screening could increase sales of the firm's drug.

    The centre's letter says that “the lineup of speakers [for the February meeting] . . . did not reflect the diversity of views on this subject, nor did the invitation reveal the conflicts of interest of virtually every invited presenter.”

    The draft letter says that some of the scientists have received grants, honorariums, and payment for speaking engagements from drug firms that make antiviral drugs for herpes.

    It says, “This is not an isolated case. Many consumer groups, professional societies, individual physicians, and medical journals have long been concerned about the role of commercial entities in influencing medical practice, from prescribing drugs to continuing medical education … When holding conferences aimed at writing guidelines, it [NIH] should seek balanced presentations. When appointing guideline writing committees, it must strive to ensure that all members are free from conflicts of interest.”

    The letter says that national guidelines on hypertension, high cholesterol concentrations, and antiretroviral treatment for children at www.guidelines.gov, a website created by the Agency for Healthcare Research and Quality of the US Department of Health and Human Services, were written by committees many of whose members were doctors with financial ties to the drug industry.