Tuesday, August 14, 2012

North American Quitline Consortium Allowing Big Pharma to Buy Its Influence on National Smoking Cessation Policy

Not only is the North American Quitline Consortium (NAQC) accepting sponsorship of its annual conference by pharmaceutical companies that manufacture products whose efficacy is discussed at the conference, but it is also providing a golden opportunity for these pharmaceutical companies to purchase influence on national smoking cessation policy.

Specifically, NAQC accepts money from pharmaceutical companies in return for giving them the ability to influence the decisions by quitlines throughout North America on whether to provide smoking cessation medications and what medications to provide. This golden access comes in the form of being designated as advisors to NAQC, being asked to provide input and guidance on cessation issues, being allowed to exhibit at NAQC's conferences, and being given access to networking opportunities with NAQC members.

The price: just money.

In return for money from pharmaceutical companies, NAQC will provide these companies with the opportunity to have significant input into their decisions on critical cessation issues, which certainly include decisions about whether to recommend and provide cessation medications, what medications to provide, and how to handle callers who want to quit on their own without medication.

According to its web site, NAQC sells membership in its Corporate Roundtable: "Membership in NAQC is limited to organizations that are engaged in quitline work. However, the Corporate Roundtable provides an opportunity for organizations to be kept updated on the progress of quitlines and to engage in a dialogue on issues of importance to quitlines and cessation. By becoming a delegate to the Corporate Roundtable, your organization can directly contribute to NAQC’s impact and influence on cessation services."

The chief benefit of being a Corporate Roundtable delegate is the ability to serve as an adviser to NAQC and provide advice on cessation issues: "Corporate Roundtable delegates serve in an advisory capacity to the NAQC, specifically giving input and providing guidance on cessation issues. Those eligible to serve as roundtable delegates include companies that produce and sell cessation medications, quitline evaluators, telephony providers, PR/media groups, and other select corporations."

On top of this, there are additional benefits:

"Additional benefits to becoming a roundtable delegate include:
  • An exhibit table, showcasing your organization, at NAQC conferences
  • An invitation to the reception at NAQC’s conferences and the opportunity to network with NAQC members in attendance
  • Acknowledgment of your involvement in the NAQC conference brochure and other conference materials
  • Recognition on the NAQC website
  • Access to bi-annual conference calls that provide updates on NAQC activities
  • Opportunities to inform NAQC members about your organization and its activities twice a year"
The Rest of the Story

So far, three pharmaceutical companies have accepted NAQC's offer and made their payoffs: Pfizer, GlaxoSmithKline, and Novartis.

This is an unprecedented opportunity to influence public policy regarding quitline services and to have input on critical questions such as the role of pharmaceuticals in smoking cessation strategy. The problem, of course, is that the advice is not objective, as it is coming from companies with a vested financial interest in the decisions.

What NAQC is doing, therefore, is giving a seat at the table to companies who have the most to gain or lose from its scientific assessments and policy decisions, thus opening up the process to severe bias.

Particularly problematic is the fact that many of the members of NAQC are government health departments, which should remain neutral and objective and should not be funded by pharmaceutical companies. While these health departments are not directly receiving money from Big Pharma, of course, the fact is that they are members of an organization whose major source of funding appears to be pharmaceutical companies.

Among the members of NAQC are the health departments in Alabama, Arizona, Arkansas, Colorado, Georgia, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Minnesota, Mississippi, Montana, Nebraska, New York, New Hampshire, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Alaska, Tennessee, Texas, Utah, Vermont, and Washington, as well as the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI).

Imagine if the Department of Health accepted money from Pfizer in exchange for allowing Pfizer to serve as an advisor to the Department on issues such as the interpretation of the risks associated with Chantix and the decision about whether to recommend Chantix to callers to the state's smoking cessation quitline. That would be a public health scandal.

Yet this is essentially what is occurring here. There is just a middle man - NAQC. But essentially, Pfizer, GlaxoSmithKline, and Novartis are paying an organization comprised of numerous state health departments to gain access as an advisor to those health departments on issues that are of critical financial importance to these companies.

In my view, this is a violation of the public's interest and a desecration of the proper role of government health agencies.

The rest of the story is that in order to preserve their integrity, the CDC, NCI, and state health departments must either: (1) demand that NAQC rescind its corporate sponsorships from pharmaceutical companies with financial conflicts of interest; or (2) rescind their memberships in the Consortium.

(Thanks to John Polito for the tip.)

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