Tuesday, October 25, 2011

Panel Chair's Disclosure Emphasizes No Personal Receipt of Funds from Endowed Chair, But Hides from Readers His Access to Tens of Thousands of Dollars

In his disclosure statement in a recent article in the New England Journal of Medicine about the treatment of smokers in the health care setting, Dr. Michael Fiore - chair of a panel that advised the Joint Commission on standards for hospital treatment of smoking - discloses the existence of his previous endowed chair position (which he recently resigned) which was funded by GlaxoSmithKline.

In the disclosure, Dr. Fiore emphasizes that no money from GlaxoSmithKline's gift was ever paid directly to him. He discloses as follows: "In 1997, the University of Wisconsin (UW) appointed me to a named Chair for the study of Nicotine Dependence made possible by a gift from GlaxoWellcome. No funds from that Chair have ever been paid directly to me and no funds from that Chair were used to pay my UW salary over the last 10 years."

The Rest of the Story

Unfortunately, this disclosure is quite misleading and if you ask me, a bit sneaky. Dr. Fiore emphasizes that he never personally received money from the endowment and that no funds from the pharmaceutical company were used to pay his salary. However, he fails to explain that under the terms of the endowed chair position, he had "access to up to $50,000 per year to support my University approved and sanctioned educational, research, and policy activities."

Thus, although he may not have received funds to himself directly, he admits in sworn testimony that he had access to up to $50,000 a year of GlaxoSmithKline money to support his work, but fails to disclose as much in the "disclosure." It does not appear that he adhered to the form's directions: "err on the side of full disclosure."

Why would one hide from readers the fact that one had access to such a huge amount of pharmaceutical company money each year to support one's work. If one is going to mention this endowed chair position, it seems important to disclose that. In fact, as Dr. Fiore told the Court in the DOJ tobacco lawsuit, that is exactly the way the endowed chairmanships work: the very idea is apparently that the interest on the endowment is accessible to the professor to support his work.

Why is this important? Because it creates the appearance that Dr. Fiore has something to hide. Why the need to deceive readers about the extent of his financial relationship with Big Pharma?

It is problematic enough to have a financially conflicted panel chair writing accreditation standards. But when that individual appears not to be forthright in disclosing the full nature of the potential conflict and appears to be hiding the full nature of his financial relationships with the pharmaceutical industry, I believe it is not only problematic, but antithetical to objective science and policy.

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