Friday, November 21, 2008

Radio psychiatrist's show dropped from NPR because of his connections to drug companies

From The New York Times. Thanks to MindFreedom for the tip.

An influential psychiatrist who served as the host of public radio’s popular “The Infinite Mind” program earned at least $1.3 million between 2000 and 2007 giving marketing lectures for drug makers, income not mentioned on the program.

The psychiatrist and radio host, Dr. Frederick K. Goodwin, (pictured) is the latest in a series of doctors and researchers whose ties to drug makers have been uncovered by Senator Charles E. Grassley, a Republican from Iowa. Dr. Goodwin, a former director of the National Institute of Mental Health, is the first media figure investigated.

Dr. Goodwin’s radio programs have often touched on subjects important to the commercial interests of the companies for which he consults. In a program broadcast on Sept. 20, 2005, Dr. Goodwin warned that children with bipolar disorder who are left untreated could suffer brain damage, a controversial view. “But as we’ll be hearing today,” Dr. Goodwin reassured his audience, “modern treatments — mood stabilizers in particular — have been proven both safe and effective in bipolar children.”

That very day, GlaxoSmithKline paid Dr. Goodwin $2,500 to give a promotional lecture for its mood stabilizer drug, Lamictal, at the Ritz Carlton Golf Resort in Naples, Fla. Indeed, Glaxo paid Dr. Goodwin more than $329,000 that year for promoting Lamictal, records given Congressional investigators show.

In an interview, Dr. Goodwin said that Bill Lichtenstein, the program’s producer, knew of his consulting activities but that neither he nor Mr. Lichtenstein thought that “getting money from drug companies could be an issue. In retrospect, that should have been disclosed.”

But Mr. Lichtenstein said that he was unaware of Dr. Goodwin’s financial ties to drug makers and that he called Dr. Goodwin earlier this year “and asked him point-blank if he was receiving funding from pharmaceutical companies, directly or indirectly, and the answer was, ‘No.’”

“The fact that he was out on the stump for pharmaceutical companies was not something we were aware of. It would have violated our agreements,” Mr.
Lichtenstein said in an interview.

Margaret Low Smith, vice president of National Public Radio, said that N.P.R. will remove “The Infinite Mind” from its satellite radio service next week, the earliest possible date. Ms. Smith said that had N.P.R. been aware of Dr. Goodwin’s financial interests, it would not have aired the program.

Sarah Alspach, a spokeswoman for Glaxo, said, “We continue to believe that healthcare professionals are responsible for making disclosures to their employers and other entities, in this case National Public Radio and its listeners.”

“The Infinite Mind” is a weekly program that has won more than 60 journalism awards over 10 years and bills itself as “public radio’s most honored and listened to health and science program.” It has more than one million listeners in more than 300 radio markets. Mr. Lichtenstein said that the last original program aired in October, that reruns have been airing since and that “the show is going off the air.”

The program has received major underwriting from the National Institutes of Health and the National Science Foundation, both of which have policies requiring grantees to disclose and manage conflicts of interest. Mr. Grassley wrote letters to both
agencies asking whether disclosure rules were followed for the grants. Spokespeople for both agencies said they were cooperating with the investigation.

Mr. Grassley is systematically asking some of the nation’s leading researchers and doctors to provide their conflict-of-interest disclosures, and Mr. Grassley is comparing those documents with records of actual payments from drug companies. The records often conflict, sometimes starkly.

In October, Mr. Grassley revealed that Dr. Charles B. Nemeroff of Emory University, one of the nation’s most influential psychiatric researchers, earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules. As a result, the National Institutes of Health suspended a $9.3 million research grant to Emory and placed restrictions on other grants, and Dr. Nemeroff relinquished his chairmanship of Emory’s psychiatry
department.

In June, the senator revealed that Harvard University’s Dr. Joseph Biederman, whose work has fueled an explosion in the use of powerful antipsychotic medicines in children, had earned at least $1.6 million from drug makers between 2000 and 2007, failed to report most of this income to his university, and may have violated federal and university research rules.

Mr. Grassley’s investigation demonstrates how deeply pharmaceutical commercial interests reach into academic medicine, and it has shown that universities are all but incapable of policing these arrangements. As a result of these revelations, almost every major medical school and medical society is now reassessing its relationships with drug and device makers.

“We know the drug companies are throwing huge amounts of money at medical researchers, and there’s no clear-cut way to know how much and exactly where,” Mr. Grassley said. “Now it looks like the same thing is happening in journalism.”

Mr. Grassley has proposed legislation that would require drug makers to publicly post all payments of $500 or more made to doctors. Eli Lilly and Merck have promised to begin posting such payments next year.

Dr. Goodwin has authored an influential textbook on bipolar disorder and is an adjunct professor at George Washington University. In an extensive interview, Dr. Goodwin blamed a changing ethical environment for any misunderstandings between himself and Mr. Lichtenstein about his consulting arrangements.

“More than 10 years ago when he and I got involved in this effort, it didn’t occur to me that my doing what every other expert in the field does might be considered a conflict of interest,” Dr. Goodwin said.

He defended the views he expressed in many of his radio programs and said that, because he consults for so many drug makers at once, he has no particular bias.

“These companies compete with each other and cancel each other out,” he said. This view is dismissed by industry critics, who say that experts who consult widely for drug makers tend to minimize the value of non-drug or older drug treatments.

In the fine print of a study he authored in 2003, Dr. Goodwin reported consulting or speaking for nine drug makers. Mr. Grassley only asked for payment information from Glaxo. Dr. Goodwin said that in recent years Glaxo paid him more than other companies.

He said that he has never given marketing lectures for antidepressant medicines like Prozac, so he saw no conflict with a program he hosted in March titled “Prozac Nation: Revisited” that he introduced by saying, “As you will hear today, there is no
credible scientific evidence linking antidepressants to violence or to suicide.”

That same week, Dr. Goodwin earned around $20,000 from Glaxo, which for years suppressed studies showing that its antidepressant, Paxil, increased suicidal behaviors.

Tom Rosenstiel, director of the Project for Excellence in Journalism, said that although concerns about media bias are growing, few people believe that journalists take money from those they cover. Disclosures like those surrounding Dr. Goodwin could change that, “so this kind of thing is very damaging,” Mr. Rosenstiel said.