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Mayo Clin Proc. Feb 2010; 85(2): 197–199.
PMCID: PMC2813833
Conflicts of Interest, Authorship, and Disclosures in Industry-Related Scientific Publications–2
We read with great interest the recent article by Hirsch1 and the accompanying editorial2 and appreciate that a venue for rational discourse has been opened. Recently, we have all witnessed increasing scrutiny and regulation of the relationship we, as clinical educators and investigators, have with our partners in industry and the continuing medical education (CME) providers with whom we work. What has been missing from this important dialogue is a concerted response from those who have worked with the pharmaceutical industry and providers of CME to present the opinion that these interactions are in fact of real value. Certain evolving institutional and national trends now in the public domain may seriously curtail the interactions between clinical educators and investigators, industry, and CME providers. This will diminish clinical investigation and education alike, with a consequent negative effect on patient care.3,4 Indeed, many institutions are considering the adoption of a “zero involvement” policy, which would substantially limit physician involvement in CME activities and new drug development. Although some rare abuses have occurred and we recognize that the risks in this interaction are real, we should nonetheless avoid overzealous, ill-judged, and restrictive regulations that will curtail the current constructive interaction.3,4 These partnerships have otherwise resulted in unprecedented advances in our field, with a subsequent dramatic improvement in patient outcome,5-12 and to impede this progress in the treatment of multiple myeloma would be a disservice to our patients and their families.
Accordingly, we as clinical researchers and educators dedicated to the treatment of multiple myeloma assert the following:
  • Synergistic interactions between physicians and the pharmaceutical industry have contributed to the development of safe and effective therapeutics that have improved individual patient outcome and thus have contributed to the greater good of society.
  • The overwhelming majority of interactions between academia and industry have been positive, productive, ethical, mutually respectful, and driven by the shared desire to bring better treatments to patients with multiple myeloma.
  • Conflict of interest concerns in these relationships have been exaggerated and diminish the integrity of physicians and coworkers engaged in clinical research in the public eye.
  • Rather than dwell on perceived worst-case scenarios, we believe that the evidence points to the overwhelmingly positive aspects of clinician-industry interaction and that a “confluence of mutual interest” exists. This congruence has served to advance the field forward faster than could ever be obtained with a “silo” approach to research, which minimizes interaction and stifles progress.
  • We believe that industry-academia interactions, conducting shared research under commonly agreed upon guidelines characterized by full disclosure and clear transparency, are in the best interests of all, and in particular our patients.
  • We believe that enforced disengagement of such partnerships will help no one and hurt many.
  • The support provided by industry for professional meetings and publications designated to promote and foster research as well as education is a major factor in contributing to the clinical development and subsequent deployment of effective therapies in a timely manner.
  • The support provided by industry to commercial CME providers, with independent review of content for fairness and balance, has resulted in the development and implementation of a variety of educational events directed toward physicians, patients, and allied health care personnel, which has improved their understanding of the disease, the benefits and risks of different treatment strategies, and the existence of additional resources to help in patient care. Through these educational events, the quality of care delivered to patients with myeloma has improved. By accelerating deployment of new therapies, lives have been prolonged and toxicities of treatment decreased.
  • We believe that this learning activity is of high value to the recipients of such education, especially to patients. As such, remuneration to experts of content and presentation for their time (often spent away from family) is reasonable, necessary, and professionally acceptable.
  • Consulting and participation in advisory boards by highly informed specialists with first-hand experience of novel therapeutics, both clinically and preclinically, are important activities of high value to industrial partners during the development of safe and effective new drugs. Optimal sharing of this knowledge occurs with investigators who care for patients and are engaged in clinical research, thus representing a bona fide exchange of information; remuneration for this work is reasonable, necessary, and professionally acceptable.
In aggregate, within the proper boundaries of full disclosure and compensation at fair market value for the effort involved, these interactions should not be limited, but rather encouraged with appropriate guidance and within agreed upon guidelines.
The importance of strengthening these relationships to further improve outcome for our patients with this otherwise incurable hematologic malignancy remains the fundamental principle guiding us. Efforts to decouple these relationships and so weaken the partnership can only be to the detriment of all, in particular our patients.
The Position Statement was authored by the following Myeloma Clinical Researchers and Educators, who fully endorse the statements herein.
Rafael Fonseca, MD, Mayo Clinic in Scottsdale, AZ; Paul Richardson, MD, Dana Farber Cancer Institute, Boston, MA; Sergio Giralt, MD, MD Anderson Cancer Center, Houston, TX; Sagar Lonial, MD, Winship Cancer Institute, Emory University, Atlanta, GA; S. Vincent Rajkumar, MD, Mayo Clinic in Rochester, MN; A. Keith Stewart, MD, Mayo Clinic in Scottsdale, AZ; William Bensinger, MD, Fred Hutchinson Cancer Research Center, Seattle, WA; George Somlo, MD, City of Hope, Duarte, CA; Robert Vescio, MD, Cedars-Sinai Medical Center, Los Angeles, CA; Joseph Mikhael, MD, Mayo Clinic in Scottsdale, AZ; Craig Reeder, MD, Mayo Clinic in Scottsdale, AZ; Rodger Tiedemann, MD, Mayo Clinic in Scottsdale, AZ; Guido Tricot, MD, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Robert Rifkin, MD, Rocky Mountain Cancer Centers, Denver, CO; John Shaughnessy, PhD, University of Arkansas; Little Rock, AR; Nikhil Munshi, MD, Dana Farber Cancer Institute, Boston, MA; Noopur Raje, MD, Massachusetts General Hospital Cancer Research, Boston, MA; Irene Ghobrial, MD, Dana Farber Cancer Institute, Boston, MA; Jacob Laubach, MD, Dana Farber Cancer Institute, Boston, MA; Robert Schlossman, MD, Dana Farber Cancer Institute, Boston, MA; Steven Treon, MD, PhD, Dana Farber Cancer Institute, Boston, MA; Anuj Mahindra, MD, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH; David Avigan, MD, Dana Farber Cancer Institute, Boston, MA; Jacalyn Rosenblatt, MD, Beth Israel Deaconess Medical Center, Boston, MA; Sundar Jagannath, MD, St. Vincent's Comprehensive Cancer Center, New York, NY; Ruben Niesvizky, MD, Weill Cornell Medical College, Cornell University, New York, NY; Heather Landau, MD, Memorial Sloan-Kettering Cancer Center, New York, NY; Selina Chen-Kiang, PhD, Weill Cornell Medical College, Cornell University, New York, NY; David S. Siegel, MD, PhD, Cancer Center of the Hackensack University Medical Center, Hackensack, NJ; Todd Zimmerman, MD, University of Chicago, Chicago, IL; Jayesh Mehta, MD, Northwestern Memorial Hospital, Chicago, IL; David Vesole, MD, Loyola University Medical Center, Maywood, IL; Steven Rosen, MD, Northwestern Memorial Hospital, Chicago, IL; Craig Hofmeister, MD, Ohio State University, Columbus, OH; Martha Lacy, MD, Mayo Clinic in Rochester, MN; Angela Dispenzieri, MD, Mayo Clinic in Rochester, MN; Ivan Borrello, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Suzanne R. Hayman, MD, Mayo Clinic in Rochester, MN; Shaji Kumar, MD, Mayo Clinic in Rochester, MN; Frances Buadi, MD, Mayo Clinic in Rochester, MN; David Dingli, MD, PhD, Mayo Clinic in Rochester, MN; Stephen Russell, MD, PhD, Mayo Clinic in Rochester, MN; Melissa Alsina, MD, Moffitt Cancer Center, Tampa, FL; Hugo Fernandez, MD, Moffitt Cancer Center, Tampa, FL; Vivek Roy, MD, Mayo Clinic in Rochester, MN; Denise Pereira, MD, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Edward Stadtmauer, MD, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Ravi Vij, MD, Washington University in St. Louis, St. Louis, MO; Andrzej Jakubowiak, MD, PhD, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Suzanne Lentzsch, MD, PhD, University of Pittsburgh Cancer Institute, Pittsburgh, PA; Kevin Song, MD, BC Cancer Agency, Vancouver, BC; Nizar Bahlis, MD, University of Calgary, Calgary, AB; Suzanne Trudel, MD, University Health Network, Princess Margaret Hospital, Toronto, ON; Christine Chen, MD, University Health Network, Princess Margaret Hospital, Toronto, ON; Donna Reece, MD, University Health Network, Princess Margaret Hospital, Toronto, ON; Douglas Stewart, MD, PhD, University of Calgary, Calgary, AB; Seema Singhal, MD, Northwestern Memorial Hospital, Chicago, IL; Raymond Comenzo, MD, PhD, Memorial Sloan-Kettering Cancer Center, New York, NY; Morie A. Gertz, MD, PhD, Mayo Clinic in Rochester, MN; Philip R. Greipp, MD, Mayo Clinic in Rochester, MN; Brian Durie, MD, Cedars-Sinai Medical Center, Los Angeles, CA; Bart Barlogie, MD, PhD, University of Arkansas; Little Rock, AR; Kenneth Anderson, MD, Dana Farber Cancer Institute, Boston, MA; William Dalton, MD, PhD, Moffitt Cancer Center, Tampa, FL; Morton Coleman, MD, Weill Cornell Medical College, Cornell University, New York, NY; Susie Novis for the International Myeloma Foundation; Robert A. Kyle, MD, Mayo Clinic in Rochester, MN
1. Hirsch LJ. Conflicts of interest, authorship, and disclosures in industry-related scientific publications: the tort bar and editorial oversight of medical journals. Mayo Clin Proc. 2009;84:811-821. [PMC free article] [PubMed]
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Articles from Mayo Clinic Proceedings are provided here courtesy of
The Mayo Foundation for Medical Education and Research