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Senator Demands Records of Psychiatric Association – Drug Industry Fiscal Ties

Senator Charles Grassley (R-Iowa) has widened his investigation of psychiatrists’ links to pharmaceutical companies to include years of financial records from the American Psychiatric Association.

Action Points

* Explain to interested patients that the American Psychiatric Association was asked to provide financial records as part of a Senate probe of ties to pharmaceutical companies.

* Explain that no wrongdoing by the group has been alleged.

In a letter sent to the APA, Sen. Grassley asked the group for “a complete accounting of APA revenues, except those from advertising in [APA] journals, from pharmaceutical companies starting in 2003,” the APA said.

The request follows probes earlier this spring by Sen. Grassley, the ranking minority member of the Senate Finance Committee, into pharmaceutical company payments to individual psychiatrists.

One of the targets was Alan F. Schatzberg, M.D., of Stanford University, who is the APA’s current president-elect. Grassley had accused Dr. Schatzberg of failing to disclose payments totaling some $74,000 from Johnson & Johnson and Eli Lilly in filings with Stanford.

Stanford responded with a statement saying that Sen. Grassley was wrong and that Dr. Schatzberg had indeed reported the payments.

The senator had also highlighted Dr. Schatzberg’s ownership of about $6 million in stock in a company called Corcept Therapeutics, which seeks to commercialize mifepristone (Mifeprex, also known as the abortifacient drug RU-486) as a treatment for depression.

The Stanford statement said Dr. Schatzberg had reported the interest and the university had taken steps “to ensure that his research was not compromised by this financial stake.”

Among them was Dr. Schatzberg’s agreement not to participate in any clinical research involving mifepristone and depression, even though he is listed as principal investigator of a current NIH-funded trial of the drug in acute psychotic depression.

Grassley also accused two Harvard-affiliated psychiatrists, Joseph Biederman, M.D., and Timothy Wilens, M.D., as well as Melissa DelBello, M.D., of the University of Cincinnati, of failing to report pharma company payments to their institutions.

Both universities are investigating the allegations.

The APA reported that pharmaceutical companies provided 29% of $62.5 million in revenues in 2006, the most recent year for which financial data were available.

Some 15% is from advertising in APA journals and exhibits at the annual meeting. Another 8% is unrestricted funding for research fellowships and resident conferences, and 6% is from industry-supported symposia at the annual meeting.

The APA reported netting about $3.7 million from the pharmaceutical funding, after expenses for these activities.

In an email sent to members last week, current APA president Nada Stotland, M.D., said the group’s board of trustees had begun a review in March of its revenues from the pharmaceutical industry.

“A working group [was] charged to review all APA pharmaceutical revenues, sort them into categories, and provide the board with options for ending pharmaceutical support in each category and the implications for the activities they currently fund,” she wrote.

The APA said Dr. Schatzberg would take over the presidency as scheduled.

Psychiatrists were also targeted last week by the Vermont state attorney general, who issued a report on pharmaceutical industry payments to doctors in the state.

Of the top 100 recipients, 11 were psychiatrists. They accounted for 20% of all monies paid to Vermont physicians.

Vermont law requires pharmaceutical companies to report payments to physicians for marketing purposes, including the specific drug products involved.

Consulting and speaking fees, travel expenses, and other direct payments were counted. Exempted were free samples, rebates and discounts, compensation for bona fide clinical-trial work, and items worth less than $25.

The attorney general’s report found that six of the 10 most heavily marketed drugs involving physicians were neuropsychiatric products: the attention deficit drugs atomoxetine (Strattera) and methylphenidate (Metadate), the antidepressants escitolapram (Lexapro) and duloxetine (Cymbalta), the antipsychotic drug quetiapine (Seroquel), and the Alzheimer treatment memantine (Namenda).

All told, 84 companies paid $3.14 million to Vermont physicians. The top 100 recipients accounted for 68% of the total.

Additional source: Vermont Attorney General’s Office
http://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/tb/10117

[14 July 2008, By John Gever, Staff Writer, MedPage Today, Reviewed by Zalman S. Agus, MD; Emeritus Professor, University of Pennsylvania School of Medicine, WASHINGTON; PharmFacts E-News Update, 15 Jul 2008 ]