Where To Find A Pharma-Free Expert
25 CommentsBy Ed Silverman // July 30th, 2008 // 8:31 am
Last May, a couple of journalists wrote a piece for Slate about a few prominent people who discussed antidepressants on a public radio show without disclosing they received funds from pharma. One was the talk-show host, Fred Goodwin, who is a former director of the National Institute of Mental Health. Another was Peter Pitts, a former FDA official, who now heads the Center for Medicine for the Public Interest, a pro-industry organization, and an exec at Manning, Selvage & Lee, a pr firm popular with pharma. (back story).
And in response to the ensuing stink, they promised to create a list of pharma-free experts for journalists. Now, most of the list is available for viewing (you need to register before gaining access to the complete set of names. Take a look). Meanwhile, the Drug & Device Law blog, which is run by two attorneys who defend pharma, are having none of it and suggest cross-referencing the names to see if any of these folks serve as expert witnesses in lawsuits against drugmakers. We have not taken that step yet, but perhaps you will enjoy the exercise yourself.
Hat tip to Torts Prof blog
Peter Pitts
Ed:
Why do you choose not to undertake this exercise yourself?
Justice in MI
Of course some of those named have served as expert witnesses. There is no secret about that; it is fully in the public domain.
The issue is about appropriate and relevant disclosure, not about what people have or have not done.
Ed Silverman
Hi Peter,
One simple reason - time. I was short on time today. I have been immersed in lawsuit documents and analyst reports. But I will get around to doing so. I put this on the site, meanwhile, so others can poke around. It’s not as if I’m the only one who can do this sort of thing, after all.
Cheers
ed
Nathan
Justice - below is a quote from the “drug and device blog”. The point of the excersize is that the list is SUPPOSED to be a list of “untainted” expert witnesses. However, as the blog points out:
“We, of course, don’t think that it’s necessarily “corrupting” for a scientist to perform work for a company and to be paid for his or her efforts. But we do think that sauce for the goose is sauce for the gander: Surely if it’s worth noting the money that certain people have received from the drug industry, it’s equally worth noting the money that other people have received from “Trial Lawyers, Inc.”
atlex
JiM,
You stated “The issue is about appropriate and relevant disclosure, not about what people have or have not done.” While I agree that part of the issue is that, the authors seem to imply that by being “pharma free” the experts listed are conflict free and bias free. If they truly wanted to be transparent, the list would have also mentioned other ties to potential conflicts–trial lawyers, consumer activist organizations, generic drug companies, health plans, etc. They might also have noted whether the list “experts” have known non-financial biases.
Atlex
Bill Childs
Justice in MI wrote: “There is no secret about that; it is fully in the public domain.”
Not entirely true. Experts who have testified in an actual trial are generally identifiable (though even that is harder than one might think); those who have merely been designated and perhaps deposed are much trickier to identify; and those who have only consulted are nearly impossible to identify.
Justice in MI
Thanks for the clarification, Bill. I have never been in a courtroom in my life, but I can identify some of the folks on the list just from news accounts. But I appreciate what you say about those “only consulted.”
I think Atlex makes a good point that ties to Nathan’s. Nobody comes from nowhere. There are biases (or convictions) that transcend whether someone gets paid or not. So it is, indeed, not always easy to sort out what should be disclosed.
If, for example, I was on the defense side, who would I think is more “biased” - an unpaid Sid Wolfe or some hack who is “on the take” for a living? The list, as I understand it, was supposed to be of those who were “independent” of pharma. I don’t know if it claimed they were independent of having opinions. But I do think relevant and rational disclosure is an ideal to be pursued, if not always clearly attained. It will be more complicated than “Us versus Them,” which is the way it’s construed in battle and in courtrooms.
Over at DDL, Bill suggested that those whose living depends on expert witnessing - or pharma lobbying - might be in a different category of concern than others. Makes sense to me.
ATG
This eight-year-old-virgin-in-a-convent-who-never-heard-of-sex-much-less-rape model for total innocence of pharmaceutical practices doesn’t really work here, does it? It is assumed that those on the pharm-free list come from planet Earth, correct?
Squeezing the analogy further– officials working on an anti-rape task force should be anything but innocent of *knowledge* of sexual assault: they just need to be innocent of committing it. They do, in some sense, owe their living to the existance of the crime but the rapists aren’t (hopefully) signing their pay checks.
If individuals who take money to testify against pharmaceutical companies are innocent of kickbacks *from* pharmaceutical companies in any capacity, they’re therefore “pharm-free”. If anyone on the list prescribes the drugs and takes so much as a cup holder from a rep (taking one as a joke to give to some anti-drug activist acquaintance and not taking the samples doesn’t count), they really don’t belong on the list.
Come to think of it, I don’t think Jeffrey LaCasse has performed as an expert witness. He did write a great paper on the myth of brain chemical imabalance though, so he has had impure thoughts regarding pharma.
Pharm Aid
I find it interesting that “an unpaid Sid Wolfe” somehow gets a pass. Does Wolfe directly profit from expert testimony on behalf of trail attorneys? I don’t know and I haven’t seen his 1099’s.
But his organization (which in turn pays his salary), has cashed checks from trial lawyers.
Splitting hairs?
It’s no different than what pharma does. They provide grants to “independent” organizations who then do their bidding.
According to an article she authored that was published in the pseudo-journal PLOS: “Adriane Fugh-Berman has accepted payment as an expert witness on the plaintiff’s side in litigation regarding menopausal hormone therapy.”
It wouldn’t surprise me if most of the names on the list shill for plaintiff’s attorneys. They may be clean of pharma money…but they ain’t clean (or independent).
Justice in MI
This has become a truly bizarre discussion. Anyone who gets paid, or is connected with anyone who gets paid, is a “shill” for whoever wrote whatever check.
So we have a world reduced to nothing but check-writers and their shills. Is that how it looks from inside the industry?
Knowing plenty of people who work there, I _know_ it doesn’t look that way. But the fact that industry’s “defenders” invoke this world of ethical cretinism tells us how far off course they have drifted.
Pharm Aid
I’ll stand by the word shill. Harsh, but appropriate.
The compiled list purports to be of “independent experts.” I Googled one name and found out she was hawking for trial lawyers. And that qualifies her as a truly independent expert? Step back from the anti-pharma/pro-pharma rhetoric for a second and just think about that.
The list that is compiled is no more and no less than a group of individuals who do not have ties to pharma. That’s it. They are “independent from pharma,” but they are not “independent experts.”
If a doctor can’t accept a $5 subway sandwhich without being taited, can an “indpendent from pharma” expert accept a $7,000 consulting and testimony fee and still be objective? I doubt it.
Justice in Michigan
Pharm Aid - Which person is that, if I may ask, who was “hawking for trail lawyers”? As I wrote above, I don’t discount the possibility that there are “on the take” types who get on such lists. But, since you raise it, it seems fair to ask whom you are talking about and the link you mention that demonstrates what you say about her.
Below the “Independent Experts” title on the list, the explanation is “Independent list members state that they do not have financial ties to drug or medical device manufacturers.” I can’t imagine it would mean anything else. Is there anyone in the world who is “independent” of having some opinion, bias, perspective, orientation?
I am strongly anti-preemption. I have never been paid anything by anyone related to anything I’ve said about the issue or the work I do related to it. So am I a shill for “Trial Lawyers, Inc.”? And if a trial lawyer invited me out to lunch to discuss my views, would I then be a shill? Does the fact that I’ve discussed them with my college roommate, who is a lawyer (a defense lawyer, as it happens) make me a shill? At what point does one stop being someone with strong beliefs and whatever relevant expertise and become a “shill”? What do they have to have done to become so? What is the threshhold of disclosure in your view? One expert witness gig five years ago? Something in the current calendar year? More than one?
My point is that reducing what are complex issues to “our shills” versus “their shills” is just a way not to talk about the genuine compleity of the issues raised.
It feels good (for a minute and a half). It teaches nothing.
Justice in Michigan
I still hope for answers to the questions above.
But, to ask it more directly, is there a single person on the list that you, or anyone, has identified who has championed the interests of trial lawyers (and been paid by them) in a way that even _remotely_ resembles the way Peter Pitts has championed the interests of the industry? (I would not use the phrase “shilled for” for him either.)
That is what started this whole thing - the suggestion of equivalence. So, again, what is the appropriate threshhold (minimal condition) which, in your view, creates such equivalence? And at which disclosure should be made - say, in the context of an NPR show? And why that threshold and not one above or below it?
Unless these kinds of questions are genuinely addressed, we’re just blowing smoke.
CMC guy
Hey Justice I agree lots of smoke but now seems getting blown back in the faces of those who created many of the fires as attempts to decredit those who do not share the same opinions.
Look no farther on the list than Marcia Angell to find an “anti-pharma” champion. So how independant is someone who authored a dubious “tell-all” book and therefore any journalist seeking her comments should not anticipate unbiased responses. There are several other names I recognize as people/organizations that have “agendas”.
Justice in MI
We all “have agendas,” CMC. I suppose it depends on how clear we are about it.
Re: the questions I raised, got no response whatsoever. That perhaps tells us something too.
Justice in Michigan
p.s. AS far as I know, Marcia Angell never served as an “expert witness” (if someone has info otherwise, I’d be interested. So CMC’s point is mute).
No claim was ever made by anyone that Marcia Angell dooes not have the opinions Marcia Angell repeatedly states she has.
Again, rather than dealing with what are actual issues and challenging questions, this “discussion” easily lapses into drivel.
Pharm Aid
By her own admission, Adriane Fugh-Berman shills for trial lawyers. Her competing interests statement from a recent paper she published in the pseudo-journal: “Adriane Fugh-Berman has accepted payment as an expert witness on the plaintiff’s side in litigation regarding menopausal hormone therapy.” Reference link:
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040150
The same folks who add their names to this list (and accept money shilling for trial lawyers) are the same individuals who criticize doctors for conflicts of interest with pharma. Ironic, don’t you think?
If someone wants to be an independent expert, then I absolutely applaud them for it. But don’t get all righteous for being anti-pharma when you (or your employer on your behalf) accept money for providing biased “expert” testimony. If you’re going to be independent, then be independent.
Justice in Michigan
AS - In your original post, you wrote, “Googled one name and found out she was hawking for trial lawyers.”
I assume the link you provide to the piece by Adriane FB is the evidence of that.
Sorry, I just don’t see it. There is, in the piece, no content that could be considered promotion of the goods and services of trial lawyers. The fact that AFB has been a paid expert witness is clearly stated in her bio blurb. What more disclosure do you think is needed?
This is certainly not comparable to Peter Pitts, whose livelihood essentially depends on promoting the interests of the industry (for which I don’t criticize him). The issue re: NPR was the absence of any disclosure of that fact.
He didn’t. She did.
Is there more to know?
Justice in Michigan
AS = PA in above.
Justice in Michigan
Broader issue here.
When this tempest in teapot first arose, the suggestion was that the list of independent experts was “rife” (DDL’s word) with people who were paid expert witnesses for “Trail Lawyers, Inc.” (again, DDL) and not disclosing it.
As it has played out, it turns out that 2 or 3 names out of a very long list have been “outed” as having been expert witnesses. And in most of those cases they have disclosed that fact.
So we end where we began. The effort to create some sort of “immoral equivalence” failed.
In the meantime, the more challenging question - what is the threshold that _should_ compel disclosure (on any side) in relevant situation remains undiscussed.
Both results are, to my mind, pathetic.
CMC guy
JIM my point about Angell was not specific as to service for trial lawyers which was way you chose to direct the question. This list is supposed to provide journalist contact sources with “Independent Experts” it appears very misleading. Again the basic point is the underlying presumption that anyone who has ties to Pharma is automatically so you can only be independent if no such relationships. So may be moot in terms of expert witness links, that now Pharm Aid clarified, but certainly is not moot that with a names like Angell, Wolfe and others it is suspect as to being very biased in intentions.
Justice in Michigan
CMC Guy - I responded precisely to the point you make. In a post above in this thread I wrote:
“Below the “Independent Experts” title on the list, the explanation is “Independent list members state that they do not have financial ties to drug or medical device manufacturers.” I can’t imagine it would mean anything else. Is there anyone in the world who is “independent” of having some opinion, bias, perspective, orientation?”
Thus, I think it would be clear to the average peruser of such a list that no one was claiming some sort of metaphysical independence, but specifcially independence of “financial ties to drug or device manufacturers.”
So, indeed, the list is full of people who have been “all-stars” in the critque of industry - Angell, Wolfe, Lurie, Goozner, Brody, et. al.. They are biased, indeed. And if someone asked me (no one has, darn it!) to comment on NPR on preemption, I would obviously also be biased.
Is there something I should disclose other than my views, which would be obvious as soon as I opened my mouth? Can “independent” only mean one has no opinion one way or other.
Can you even imagine such a person would even be asked to be on NPR. “And now, we turn to Dr. John Smith, who has no opinion whatsoever on the issue we are discussing.”
Would be as really compelling and informative show.
Justice in Michigan
In fairness and in the interest of clarity -
If I were a paid, essentially full-time lobbyist for “Trial Lawyers, Inc.” - whatever independent convictions and relevant experience I thought I had - I would certainly feel obligated that that fact be known if I were to speak publicly on an issue in which my “client” had a direct interest.
From what I know, none of the poeple on the list have even close to that kind of relationship with lawyers. But it was pretty close to the situation on the “other side” that started all of this.
Pharm Aid
Adriane Fugh-Berman has shilled for trial lawyers. She admitted it in her own article. Reference the link. The link also shows that there is a political agenda behind her work.
It is worth stating that the list was created by discredited journalist Jeanne Lenzer. Lenzer’s own lengthy relationships with trail lawyers was chronicled in the Jan. 17, 2005 issue of the New York Times (article by Barry Meier). Lenzer’s employer has had to apologize to pharmaceutical companies for her lapses in credibility and integrity. This alone should make the entire list suspect.
This list is a shill list for trial lawyers. Period.
I wouldn’t have ANY objections if the two pseudo-journalists who created it (Lenzer and Brownlee) said only that it was a list of pharma-free experts. However, when they begin to introduce the word “independent,” I take exception (hell, they call their list INDEPENDENT EXPERTS). This is nothing less than an INTENTIONAL mis-representation of these individuals.
You can split hairs and ask: is Peter Pitts more of shill than Lenzer is a shill? I wouldn’t call Pitts indepdent and I won’t call anyone on this list indepedent either. If the issue behind all of this is UNDISCLOSED conflicts of interest in the industry, then the anti-pharma foes of Lenzer, et al, are just as guilty as Peter Pitts and the pro-pharma shills. Pitts didn’t close on NPR and Lenzer and the trial lawyer shills aren’t disclosing either.
[Sorry it took me so long to respond, but I don't get on the computer all the time.]
Expand the Argument
The argument isn’t about whether or not the speakers on NPR had conflicts of interest. It is whether the obviously inaccurate information that they presented was due to these conflicts of interests.
See http://chemicalimbalance.org/?p=113