Thursday, January 23, 2014

CDC is Intentionally Hiding Conflicts of Interest of Surgeon General's Report Authors

Earlier this week, I revealed that the 2014 Surgeon General's report fails to disclose the conflicts of interest of its authors, many of whom have received money from pharmaceutical companies which manufacture the very products about which the report opines. I also explained how this is particularly problematic, since the report itself complains about how historically, tobacco-funded scientists failed to disclose their conflicts of interest. I concluded that the 2014 Surgeon General's report is violating the very ethical principles that it attacks the tobacco company for violating in the past, and I note that while there has been substantial progress in the past 50 years in the area of disclosure of conflicts of interest, somehow that progress has evaded the producers of the Surgeon General's report itself.

Today, I reveal that the CDC's Office on Smoking and Health (OSH) - the lead agency that produces the report - is apparently intentionally hiding the conflicts of interest. In other words, OSH knows about these conflicts but has apparently decided not to share this information with the public. That is, OSH is intentionally hiding these conflicts from the public.

The Rest of the Story

Yesterday, I was informed by one of the contributing authors to the 2014 Surgeon General's report that each of the authors and reviewers of the report was required to complete conflict of interest disclosure forms. This makes the problem even more serious than it initially appeared. It now seems that this is not merely a matter of the CDC not knowing about, or failing to inquire about the conflicts of interest of report authors. Instead, this is now a matter of the CDC hiding, or covering up, these conflicts of interest, which are not revealed to the public anywhere in the report or on the report's web site.

There is no excuse for collecting this important information, but not revealing it to the public. The only legitimate justification for this would be if there were no reported conflicts of interest. In such a case, the report could have included a statement indicating that none of the report's authors reported a conflict of interest.

But we know this is not the case because in journal articles published by many of the report authors, they have acknowledged multiple conflicts of interest with Big Pharma.

Let's just take three of the Surgeon General's report authors alone (Dr. Neal Benowitz, Dr. Jack Henningfield, and Dr. Jonathan Samet). According to a D.C. District Court brief filed by R.J. Reynolds and Lorillard:

Dr. Benowitz: "Dr. Benowitz, as a paid consultant for pharmaceutical companies, has assisted them with the design, development, and marketing of smoking-cessation products. Among the companies for which he has consulted on such products are GlaxoSmithKline plc and its affiliates (collectively, “GSK”); Pfizer, Inc. and its affiliates (collectively, “Pfizer”); Novartis AG and its affiliates (collectively, “Novartis”); Sanofi-Aventis U.S. LLC and its affiliates (collectively, “Sanofi-Aventis”); and Aradigm Corp. and its affiliates (collectively, “Aradigm”). During the last ten years, he has received at least approximately $10,000 per year for such consulting. He has also received grant support for research and writing from GSK and/or Pfizer on at least five occasions. In 2010, he co-authored a study, funded by Pfizer, on the use of its drug, Chantix, for smoking cessation."

Dr. Henningfield: "Dr. Henningfield is a Principal at, and derives most of his income from, Pinney Associates, a firm that currently provides to GSK on an exclusive basis consulting services regarding smoking-cessation products. His formal title is: Vice President, Research & Health Policy. Through his association with Pinney Associates, Dr. Henningfield advises GSK specifically on the development of nicotine-replacement therapies and treatments for tobacco dependence. Pinney Associates has received on average more than $2 million per year in revenue from pharmaceutical companies, more than half of which relates to smoking-cessation products. In addition, during the last decade, Dr. Henningfield has received grant support for research and writing from GSK on at least eight occasions. Dr. Henningfield is also a partner in a company that holds patents for a nicotine replacement-therapy product. He has estimated that, if thess patents are successfully licensed, they could be worth more than $1 million to him as a partner in that company. Thus, Dr. Henningfield has a financial interest in bringing about regulatory policies that will drive current smokers to use nicotine-replacement-therapy products."

Dr. Samet: "During the last decade, Dr. Samet has received grant support for research and writing from GSK on at least six occasions, including in 2010. In addition, he formerly led the Institute for Global Tobacco Control, which is funded by GSK and Pfizer. Moreover, until 2009, Dr. Samet received regular honoraria from Pfizer for his service on the Pfizer Global Tobacco Advisory Board."

Thus, as revealed and described in this lawsuit brief and in an accompanying press release: "Drs. Neil Benowitz, Jack E. Henningfield and Jonathan M. Samet are conflicted ... due to their continuing financial relationships with pharmaceutical companies that make smoking-cessation products."

Incidentally, the Reynolds/Lorillard lawsuit seeks to have Drs. Benowitz, Henningfield, and Samet dismissed from the FDA's TPSAC (Tobacco Product Scientific Advisory Committee) panel because of these conflicts of interest. While these conflicts do not preclude the participation of these scientists as authors of the Surgeon General's report, they absolutely must be disclosed to the public.

To make matters worse, Dr. Samet is not just an author, but served as one of the two editors of the report.

The rest of the story is that not only is CDC failing to disclose the important conflicts of interest of the 2014 Surgeon General's report authors, but OSH is involved in a cover-up. Apparently, OSH has deliberately chosen to hide these conflicts of interest from the public.

It may take a Freedom of Interest Act (FOIA) request to obtain this information from OSH, or wherever this "secret" information resides, which is quite a shame given the fact that one of the major points made in the Surgeon General's report is its criticism of the unethical behavior of tobacco industry scientists who hid their financial relationships with the industry. It's sad that the federal government is condemning the past actions of scientists who hid financial connections with Big Tobacco, while it is engaging in the present action of hiding financial connections with Big Pharma.

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