Ethicists Prod NIH to Spend Money Investigating Conflicts of Interest

November 17, 2009

Today marks three months in office for Francis S. Collins, director of the National Institutes of Health. His anniversary present from a group of researchers and ethicists was a new plea to do something about financial conflicts of interest in medical research.

Dr. Collins was sent a letter today from 96 people, including a former editor of the New England Journal of Medicine and representatives of the leading association of medical students, asking why the NIH, with a $30-billion annual budget, doesn't spend more of that money to ensure that it is financing unbiased scientific research.

"The recent disclosure of ghostwritten articles, physician payoffs, and the use of academic opinion leaders to increase markets for FDA-regulated products," the letter said, "indicate that ethical lapses may permeate biomedical research."

The letter was organized by PharmedOut, a project established by the Georgetown University Medical Center to educate physicians on ways the pharmaceutical industry influences their decisions on prescriptions.

Groups represented by those signing the letter include the Public Library of Science, the American Medical Student Association, the National Physicians Alliance and the Consumers Union. Individual signers include Jerome P. Kassirer, former editor in chief of the New England Journal of Medicine, and Susan F. Wood, who resigned as director of women's health research at the federal Food and Drug Administration in 2005 to protest political influence inside the agency.

Even with an extra $10-billion from the federal economic stimulus measure, the NIH still has "no mechanism for funding research on how commercial interests affect the choice of medical therapeutics," said Adriane Fugh-Berman, an associate professor at the Georgetown University Medical Center who directs the PharmedOut project.

An NIH spokesman said the agency had no immediate comment, but one bioethicist—who did not sign the letter—said Dr. Collins could be receptive. Thomas H. Murray, president of the Hastings Center, a nonpartisan and nonprofit bioethics research institute in New York, noted that the letter does not ask for much. It requests the director to acknowledge the need for greater research into financial conflicts of interest and then "set in motion" a process for addressing the need, said Mr. Murray. "The letter is actually quite gentle and modest in what it requests," he said.