Investigation into National Academies reveals recent industry ties among scientists advising the US government on opioid policies
* Almost half of advisors disclosed recent ties to drug or healthcare industry
* National Academy of Medicine president has since disclosed his interests
* Expert calls situation “inexcusable” in light of US opioid addiction crisis
* Questions remain around funding from Sackler family, owners of Purdue Pharma
As the US suffers an epidemic of opioid deaths linked to overprescribing, an investigation published by The BMJ today finds that a scientific body that advises the FDA on opioid policies has not publicly disclosed that one of its presidents, and members of a panel it has convened to advise on prescribing opioids, had recent links to industry.
As a result of The BMJ's investigation into the National Academies of Sciences, Engineering and Medicine (NASEM), a number of articles in medical journals by National Academy of Medicine president Victor Dzau now belatedly disclose his financial ties to several companies.
Prominently, this includes JAMA issuing corrections to two articles Dzau co-authored on opioids to disclose his ties to Medtronic, which sells an implantable device that delivers pain medicine.
Dzau told The BMJ that he resigned from all commercial relationships and divested the holdings before joining the academies in 2014 and that the Medtronic shares he owned till 2018 were “deferred compensation” that he could not divest from earlier because of US tax rules.
Dzau also told The BMJ that his ties didn't represent any conflict of interest and that he had complied with journal policies, but he was making belated disclosures for the sake of caution and transparency.
The BMJ also investigates the 15 academics appointed to a new NASEM panel examining opioid prescription guidelines. The panelists are free of conflicts of interest, according to NASEM. But The BMJ has uncovered that seven panelists disclosed ties to the drug or healthcare industry in recent scholarly work on pain. The taxpayer-funded panel was commissioned by the FDA.
The BMJ's reporting highlights NASEM's extremely narrow conflicts-of-interest policy, which only examines panelists' “current” financial interests. Lisa Bero, who researches scientific integrity at the University of Sydney, notes that almost all medical research bodies require public disclosure of previous financial interests, usually going back three years.
The BMJ also reports that NASEM has received between $10m and $25m from the Sackler family, owners of Purdue Pharma which makes the opioid painkiller Oxycontin.
Dzau told The BMJ that he has no control over how NASEM allocates funding from the Sacklers.
Andrew Kolodny, co-director of opioid policy research at Brandeis University, sees the academies’ recruitment of scientists with recent ties to opioid manufacturers as “inexcusable when one considers the history of our opioid addiction epidemic.”
“The reason we wound up here is precisely because of a failure to regulate conflicts of interest,” Kolodny told The BMJ. “We had doctors with financial ties to opioid manufacturers working on guidelines that call for much more aggressive prescribing.”
The academies have attracted concerns before about their failure to disclose conflicts of interest, and in 2017 announced that they were revamping their conflict of interest policies. Yet two years later, the academies’ 2003 policy stands.
NASEM told The BMJ that Victor Dzau has disclosed all his financial interests to them privately and complies with their policy. But they declined to provide Dzau’s disclosures, or any examples of them having publicly disclosed Dzau’s industry ties or asking Dzau to recuse himself from academies’ activities.
Dzau has repeatedly distanced himself from the work of the academies’ current opioids panel, telling The BMJ he has no “direct oversight.” He currently chairs a NASEM-led public-private partnership aimed at countering the opioid addiction crisis.
As the president of the National Academy of Medicine, his official duties also include setting “a high standard of intellectual integrity, neutrality, and honesty in all that NAM does.”
Notes to Editors
Feature: US opioid prescribing: the federal government advisers with recent ties to big pharma
Journal: The BMJ
Link to Academy of Medical Sciences press release labelling system: https://press.psprings.co.uk/
Evidence type: Investigation
Link to full investigation: https://www.bmj.com/content/
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