Guideline Committees and Patient Advocacy Groups Report Ties to Industry

01/18/17

Guideline committees and patient advocacy groups have reported substantial ties to industry, falling short of the Institute of Medicine’s standards regarding conflict of interest, according to research published in JAMA Internal Medicine.

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Researchers led by Akilah A Jefferson, MD, MSc, and Steven D Pearson, MD, MSc, both from the Clinical Center, Department of Bioethics, National Institutes of Health (Bethesda, MD), investigated the extent to which committees that formed two sets of guidelines—the American College of Cardiology and American Heart Association cholesterol management guideline as well as the American Association for the Study of Liver Diseases and Infectious Diseases Society of America Hepatitis-C management guideline—adhered to the Institute of Medicine’s standards regarding conflict of interest in financial and intellectual relationships.

The Institute of Medicine’s current standards prohibit any guideline committee chairs from having commercial conflict of interest and < 50% of committee members from having commercial conflict of interest. Results of the investigation showed that 33% of chairs for the cholesterol guideline committee disclosed commercial conflict of interest, 67% of chairs from the Hepatitis-C guideline committee disclosed commercial conflict of interest, and 72% of members from the Hepatitis-C guideline committee reported commercial conflict of interest.

Authors of the report noted that the presence of conflict of interest does not necessarily indicate improper influence, but “the recommendations of the cholesterol and Hepatitis-C guidelines evaluated herein differ from contemporaneous guidelines in a way that adds to questions about the possible influence of commercial conflict of interest."

In a study regarding ties to industry for patient advocacy organizations, Susannah L Rose, PhD, Department of Bioethics, Cleveland Clinic (OH), and colleagues sent surveys to 439 patient advocacy organization leaders. Of the 289 leaders that responded, 67% disclosed receiving industry funding with nearly 12% receiving more than half of their funding from industry. Most of the funding came from pharmaceutical, device, and biotechnology companies. Approximately 8% of leaders reported pressure “to conform their positions to the interests of corporate donors.”

Authors of an accompanying editorial warn of the potential harm in the lack of protest from industry-sponsored patient advocacy groups, as such with the recent rise in price of the EpiPen (epinephrine injection, USP; Mylan).

"In our view this new work demonstrates an urgent need for patient advocacy organizations to explicitly focus much more on representing the interests of patients and citizens, rather than serving — inadvertently or otherwise — the interests of their industry sponsors," the editorialists write