Hot Flash! Menopause And Money
7 CommentsBy Ed Silverman // March 9th, 2007 // 3:42 pm
A few weeks ago, a non-profit called the North American Menopause Society issued a position paper suggesting hormone replacement therapies aren’t as risky for women between 45 and 55 years old, compared with older women. This was issued just as several lawsuits were getting under way in state and federal courts. They were filed by women who claim their breast cancer was caused by a leading HRT known as Prempro, which is sold by Wyeth.
At the time, the NAMS executive director, Wulf Utian, took pains to downplay any influence Wyeth may wield. In response to questions, he acknowledged that NAMS receives funding from Wyeth, but also many other drugmakers. He said that industry funds weren’t used to underwrite the position paper. And the paper disclosed numerous ties between drugmakers and the panelists who wrote the statement. It was all arm’s length and out in the open, he said.
Then, last month, another group called the International Association of Compounding Pharmacies accused of NAMS and Utian of being less than fully transparent. They fired off a press release of their own saying Utian and NAMS didn’t dislclose financial ties to Wyeth. Why does IACP care? Well, Wyeth has filed a citizen’s petition with the FDA to stop compounding pharmacies from making bioidentical versions of Prempro. The move is in Wyeth’s interest, but is causing a ruckus. So IACP is protecting its own interests, too.
In making its case, however, IACP pointed to a remark Utian made last November, when he appeared on The Larry King Live Show on CNN to debate bioidentical HRTs. When confronted by another guest, he said: “I am not funded by Wyeth Pharmaceuticals. I’m not.”
Pharmalot was curious and contacted Utian. In an e-mail, he wrote that “I am not NAMS.” The group, he maintained, is “completely transparent,” all sources of income are fully disclosed, and he isn’t a full-time NAMS employee. He also noted that some compounding pharmacies contribute to NAMS.
But there are rather specific ties to Wyeth. To find them, however, its best to wear hunting gear. Some can be located on the NAMS web site. For instance, Wyeth provides unspecified grants and contributed $8,000 a year in fees for an education program. Wyeth also gave $200,000 to the NAMS/Wyeth Wulf H. Utian Endowed Lectureship.
The web site doesn’t tell the whole story, though. The 990 tax form NAMS filed with the IRS for 2005 shows that Utian was paid $128,750. And after requests for more complete info about Wyeth’s backing, a NAMS official wrote that the group last year received nearly $1.8 milllion from 39 healthcare companies. Wyeth was responsible for 7.7 percent, or roughly $140,000. That’s not much more than Utian’s part-time salary.
“NAMS can take whatever position it wants,” says L.D. King, IACP’s executive director, who insists LD doesn’t stand for Low Dose. “We simply think there should be transparency.”
He has a point. When asked about these financial ties, Utian responded that critics “are looking for something that does not exist….I have been involved in menopause related clinical care, research and teaching for well over 40 years with literally, hundreds of publications showing a process of thought change as the the science has evolved,” he wrote. “Throughout, I have fought diligently to keep myself as an independent thought leader and not a lackey of any industrial concern….I reaffirm that I am independent and that NAMS is a transparent scientific organiziation.”
No sense in arguing. There is a perception issue, one that plagues the entire industry. And as an educated, thoughtful fellow, Utian should understand this. NAMS is free to publish a paper. And Utian is free to accept compensation from an organization funded by drugmakers. But there ought to be full disclosure about any connections if NAMS is going to advocate a position that benefits one of its key backers. The NAMS web site doesn’t do enough to make that clear. And neither does Utian.
[tags]International Association of Compounding Pharmacies, Menopause, North American Menopause Society, Prempro, Wyeth[/tags]
Julia Schopick
Ed: This is one of the best summaries of the Compounding Pharmacy/Wyeth controversy that I have read thus far.
Dr. Utian proclaims: “I have fought diligently to keep myself as an independent thought leader and not a lackey of any industrial concern….I reaffirm that I am independent. . . ”
Does he really think that no one will check to see if he is telling the truth? Dr. Utian seems to believe that the veracity of his statements won’t be challenged.
I did a quick search of his name in the Integrity of Science Database. This database is a project of the Center for Science in the Public Interest, and contains a wealth of information on financial ties between specific medical researchers and industry.
My search turned up numerous instances of possible conflicts of interest: (a) eleven instances of Dr. Utian’s being on the advisory boards of, and a consultant to, pharmaceutical companies, and (b) 24 pharmaceutical companies – including Wyeth – from which he has received research funding.
More specifically, his Integrity of Science Database listing says:
Wulf H. Utian, M.D., Ph. D., Professor Emeritus, Department of Reproductive Biology, Case Western Reserve University, Cleveland. On advisory board for, and consultant to, Barr, Duramed, Berlex, Johnson & Johnson, Merck, Merrion, Novartis, Organon, Pfizer, Roche, and GlaxoSmithKline. Received research funding from Amylin, 3M, Barr, Berlex, Bristol-Myers Squibb, Duramed, Eli Lilly, Forest, Glen, GlaxoSmithKline, Johnson & Johnson, Neurocrine Biosciences, Novartis, Novo Nordisk, Organon, Pharmacia, Procter & Gamble, Pfizer, Roche, Sepracor, Solvay, Wyeth, and Yamanouchi. (http://www.medscape.com/viewarticle/515692, accessed 2/01/07)
This database can be accessed (and searched) at http://www.cspinet.org/cgi-bin/integrity.cgi .
So, it seems that Wyeth may well be just one of Dr. Utian’s many connections to Big Pharma. It would take hours of research to find out exactly how connected he is to each company listed, when that connection occurred, and how much money he has received from each. But I must admit that I find this short roundup to be quite discouraging.
Remember the days when we could trust physicians to really care about us, and we didn’t have to worry that they were on Big Pharma’s dole?
I first became fascinated by this topic when I did research for a 3-part article I wrote, “The JAMA Controversy,” about connections between Big Pharma and several researchers/physicians who published their controversial study findings in JAMA. David Armstrong of the “Wall Street Journal” broke the story. I was following up. (See http://honestmedicine.typepad.com/medical_watch/2006/08/introducing_jam.html .)
As a public relations consultant myself, I was particularly disturbed when I found that JAMA had actually heavily promoted the results of the controversial study in question, with a press release AND a video news release (a VNR, or “fake news”). In my article, I provided links to the actual videos and releases.
Keep up the good work, Ed. I am going to forward the link to your posting about the Wyeth/Compounding Pharmacy controversy to lots of people.
Julia Schopick
jttp://www.honestmedicine.typepad.com
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Sue Huss
When they can’t sell women on HRT anymore they try to sell them on Neurotin for hot flashes. For those of you who don’t know Neurotin is a anti-siezure medicine with terrible side effects. What’s next?