Monday, October 31, 2011

Do Significant Conflicts of Interest Disappear Overnight? Researcher Fails to Disclose Previous 12-Year Big Pharma Financial Relationship

How long is a financial conflict of interest still a conflict? And for how long after a conflict "ceases to exist" should a researcher continue to disclose that conflict? These intriguing questions are raised in today's Rest of the Story.

Last week, I discussed how a researcher who has made substantial contributions to the field of treatment of patients for smoking cessation - Dr. Michael Fiore - had a significant conflict of interest with Big Pharma by virtue of his position as a chair endowed by GlaxoSmithKline, which he acknowledged gave him "access to up to $50,000 per year to support [his] University approved and sanctioned educational, research, and policy activities."

This chair position was apparently held by Dr. Fiore from 1997 until February 2010, when he resigned the position.

It appears that in at least some of his current publications, Dr. Fiore has stopped disclosing this conflict of interest to readers.

In a recent set of two articles on treatment for smoking cessation published in the Annals of Behavioral Medicine in April 2011 (article 1; article 2), the conflict of interest statement regarding Dr. Fiore states only that: "Over the last 3 years, Michael C. Fiore served as an investigator on research studies at the University of Wisconsin that were funded by Nabi Biopharmaceuticals." These articles give no indication that as of the start of 2010, and for the previous 13 years, Dr. Fiore held a chair position endowed by GlaxoSmithKline.

In August 2011, an erratum to the latter article was published. This would have been an opportunity to correct the disclosure statement had the omission of mention of the Big Pharma endowed chair position had merely been an oversight.

In a December 2010 article on treatment for smoking cessation published in the Wisconsin Medical Journal, the conflict of interest statement regarding Dr. Fiore states only that: "Over the last 3 years, Dr Fiore has served as an investigator in research studies at the University of Wisconsin that were funded by Pfizer and Nabi Biopharmaceuticals." Again, the article gives no indication that as of the start of 2010, and for the previous 13 years, Dr. Fiore held a chair position endowed by GlaxoSmithKline.

The Rest of the Story

In my opinion, a conflict of interest does not disappear overnight. In the present case, I believe that the existence of a 13 year period during which the researcher held a Big Pharma endowed chair position is absolutely relevant today, even though the researcher has resigned that position. I believe that readers deserve to be informed about that 13-year financial relationship between the researcher and the pharmaceutical industry and that this relationship is relevant to the evaluation of potential bias in the conduct and reporting of the research, even though the relationship ceased to exist in early 2010. Thus, I believe that the conflict should continue to be reported and that the investigator has an obligation to inform journal readers of the past financial relationship.

Imagine if a scientist at Philip Morris resigned his position to take a job at an academic institution. Now imagine that scientist published a tobacco-related paper in a scientific journal but failed to disclose his past employment by Philip Morris. I can guarantee that we in the tobacco control community would be attacking that scientist for failing to disclose his prior employment at Philip Morris.

Clearly, a significant conflict of interest does not simply disappear overnight. And I would argue that the forthrightness which we would expect from tobacco industry researchers is the same that we should expect from tobacco control researchers. Past conflicts of interest should be disclosed if they are significant and relevant. Certainly, a 13-year financial relationship with a pharmaceutical company, in which a researcher holds a chair position endowed by that company and has access to tens of thousands of dollars to support his work constitutes a significant and relevant financial conflict of interest.

And no, that conflict does not simply disappear overnight.

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