Friday, 14 December 2012

What can happen when neurologists get too close to industry?

#MSBlog: Insider trading; another blow to the credibility of neurologists working with industry

Drew Armstrong. Michigan Professor Tied to Insider Trading Case Resigns. Bloomberg News November 30, 2012.

.... Sid Gilman, the University of Michigan neurologist linked to an insider trading case, has resigned his university position.....

.... Gilman, 80 was named by authorities as the person who leaked data to Mathew Martoma, 38, an SAC Capital Advisors LP hedge fund manager charged with insider trading. Gilman quit his university post on Nov. 27, Pete Barkey, a spokesman for the Ann Arbor-based university’s medical school, said in an e-mail......

...... Gilman had been paid $1,000 an hour to act as a consultant to Martoma and in 2008 allegedly gave the hedge fund manager details of a clinical trial for an Alzheimer’s drug being developed by Wyeth LLC. The neurologist treated Martoma as a “friend and pupil” while leaking him secret data for 18 months, authorities said.......




"This is bad news for the field. After my experience with business analysts at the official press conference after my presentation at the AAN, on the pivotal oral cladribine results, I made a conscious decision not to speak to business analysts in private. Unfortunately, you can't avoid them at conferences. When you present market sensitive results either as a platform presentation, or as a poster, more than 50% of the people wanting additional information are either business analysts or pharma employees from competitive companies. It is very difficult, if not impossible, to define any safe ground with them. Saying no is easier than justifying why you said yes; and it is obviously worse if you get paid $1,000 per hour for saying yes."

"And we (neurologists) wonder why we  have lost, or are losing, credibility. These types of stories provide the fodder for the conspiracy theories that underpin the CCSVI anti-science campaign! "

12 comments:

  1. I not he is an American neurologist. If You're So Smart, How Come You're Not Rich? This is the American moto!

    http://www.academicearth.org/lectures/if-youre-so-smart-how-come-youre-not-rich

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    1. Dispicable and so is the attempt to draw ccsvi into the same mix, where there is increasing robust Science.

      Regards as always

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    2. Relax Andy Prof G is just busting balls! We'll have to see how "robust" the science is after the studies report from groups that have no vested interest in the results.

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    3. Prof G is right; the CCSVI lobby refuse to listen to or accept the science. All they do is attack anyone who does. Where is the evidence to the contrary; that is without conflicts of interest. This excludes all of Zamboni's work.

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    4. There is a randomized controlled study launching in Canada. This would be a nonvested group. But the interventional radiologists in the study have never performed the CCSVI venoplasty. How hard can it be, right? Should high pressure balloons be used? Is intravascular ultrasound necessary to minimize vein injury through proper sizing of the balloon? What is the proper sizing of the balloon? What anticoagulation regimen should be used, if any? What follow-ups, and what should be done if thrombosis is identified? What will qualify as a treatable lesion? An undersized balloon will lead to a return of the stenosis to its original state. An oversized balloon can lead to vein injury. High pressure balloons can cause more damage if used incorrectly but can result in greater durability of treatment result if used correctly. Apparent stenoses in the upper jugular may be physiological stenoses caused by muscular or bone compression and relieved by turning the head or other movement; these should not be treated, especially not by stents, because skull base or atlas compression can compress stents within the vein leading to worsened outflow. These statements cannot be verified without further research. My point is that there are many technical aspects to the treatment of intraluminal vascular malformations of the jugular and azygous veins. An IR who has never treated these veins cannot be expected to have expertise in such treatment, and a randomized controlled trial should be performed only after these IRs have gained expertise. The nonvested trial in Canada is sadly lacking in this regard.

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    5. So doomed to failure, before it starts?

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    6. Hmmm. The British Vascular Society is equally sceptical of CCSVI and MS. I think they know a thing or two about vein surgery...

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  2. Prof G,

    I see medicine as a calling - you join the profession to help people get better / not get worse etc. Many GPs do this. I also see medicine as a public good. Drs / consultants earn a reasonable salary and the rewards of doing the job should be sufficient. However, the lure of money has muddied all this. Neurology one of the worst examples - consulting fees for drugs companies etc. etc. I'm amazed how many research neuros set up companies with the hope that drugs they invent (often using public money) will bring them mega bucks. I'd have real respect for a research neuro who has never taken a cent from a drugs company. Sadly, I doubt there are many left. Finding a cure for MS or treatments which make the lives of MSers better should be reward enough - do they really need to line their pockets with money from commercial companies? There are strict rules for other public sector organisations e.g. Civil servants in the Department of Transport would not be allowed to accept payments from BA or the train companies. Drs are public servants - training, salaries and pension paid by taxpayers money. If they want to work for the private sector, join BUPA or a drugs company. Having a foot in both is the worst situation. It's a shame that those interested in making lots of money see medicine as the route - they should have gone into banking. I'm guessing one of he reasons MS drugs are so pricey is that the companies have so many neuros on their books!

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    1. Some of this is true, but it is often not cost-effective for Pharma companies to hire full-time neurologists to run their clinical development programmes. They then need to hire consultants to help then design and run their studies. You have to remember that drug development does not happen outside of Pharma! I can't think of a single example in neurology or more specifically MS.

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