Letters from Grassley: Questions 33 Medical Groups on Financial Support from Industry

Continuing his “ongoing probe into conflicts of interest” Senator Chuck Grassley this week sent letters to the American Medical Association, Alzheimer’s Association, the American Cancer Society and 30 other disease and medical advocacy organizations asking them to provide details about the amount of money that they and their directors receive from drug and device makers.

According to the  New York Times, Mike Lynch, a spokesman for the A.M.A., said the organization had received the senator’s letter and would respond.

Mr. Lynch also told NYT that “industry funding comprised less than 2 percent of the organization’s budget.” Steve Weiss, a spokesman for the American Cancer Society, and Kate Meyer, a spokeswoman for the Alzheimer’s Association, also noted they would respond to Senator Grassley’s letter.

What may be motivating Mr. Grassley is his idea that charities and non-profit organizations, which can have a lot of influence over public policy, are “influenced by drug and device makers on the practice of medicine.”

The articles and letter try to portray this problem by bringing up a similar letter that Mr. Grassley sent to the National Alliance on Mental Illness (NAMI). Such a comparison is misguided because while NAMI had a significant portion of its funding from industry, the AMA has only 2%.

The article also attempted to overstate the impact of NAMI’s funding by highlighting one board member of NAMI’s choice to resign. The e-mail announcing his resignation however, acknowledges that Dr. Lamb knew about such funding for five years. Although he advocated for changes in funding, it is uncertain exactly what he did as a board member to realize such a goal. 

Accordingly, Mr. Grassley’s leter cited an April 2009 Institute of Medicine report that “endorsed transparency … without inhibiting productive relationships between medicine and industry.” While the Senator hopes that operating with such transparency will send a message that “there is nothing to hide,” physicians and their associations are uncertain how the media will handle such information given their track record.

 

Recent practice tends to show sensationalist headlines that highlight the numbers ($) instead of what the payment is for (e.g. research, consulting, etc.), and the benefits such involvement has for patients.

 

Grassley’s Letter

By December 21, 2009, Senator Grassley asked that the associations send an accounting of industry funding that pharmaceutical and medical device companies have provided including the:

1) Year;

2) Name of company;

3) Amount of funding; and

4) Reason(s) that the funding was provided.

 

Senator Grassley also wants the associations to explain its policies for accepting industry funding and the disclosure requirements of their top executives and board members by answering the following questions, regarding January 2006 to the present:

 

1) Please describe the policies for accepting industry funding and whether or not the medical society allows companies to place restrictions or provide guidance on how funding will be spent.

 

2) If the association allows companies to place restrictions on industry funding, then please explain all restrictions and/or guidance for each transfer of value from industry.  For every transfer of value with a restriction, please provide the following information: year of transfer, name of company, and restriction placed on funding.

 

3) Please explain what policies, if any that the association plans to adopt to ensure transparency of funding in order to provide a greater public trust in the independence of your organization.

 

4) Please explain your policies on disclosure of outside income by your top

executives and board members.

 

5) Please provide the disclosures of outside income filed with your organizations by your top executives and board members.

 

While AMA has already asserted that only 2% of its funding comes from industry, it is uncertain what percent of funding comes from industry for the other 32 organizations.

It is interesting to note that the organizations quoted in the press receiving letters from Senator Grassley include: Alzheimer’s Association,  American Cancer Society, and the American Medical Association have all come out strongly in favor of health care reform bills currently before congress. 

A full list of societies receiving the letter includes both patient and professional organizations.

Patient organizations are the next focus for the Institute of Medicine as a Profession (authors of the JAMA recommendation special communication papers on conflict of interest in Medical Societies and Medical Schools).   IMAP plans to release a report sometime in 2010 calling for a separation of industry funding from patient groups.

We have frequently discussed the important role industry funding has (e.g. resources, grants, research) for such entities.   

Mr. Grassley’s probe in support of sunshine, will affect thousands of physicians and patients around the country.   It will be worth watching what they eventually do with the data that they collect, they have the opportunity to use the aggregate to promote discussion or they can release the information without context to the press.

References

Senator Grassley: Medical Society Letter December 7, 2009

    Letters of Inquiry by Recipient List

New York Times:  Senator Grassley Seeks Financial Data from Medical Groups

Wall Street Journal: Grassley Asks Non Profit Groups About Financial Support