Investigations Continue into Psychiatrists-Big Pharm Ties

Dr. Martin Keller, head of psychiatry at Brown University, is likely to be the next target in ongoing congressional investigations into the often too-friendly relationship between some doctors and pharmaceutical companies.  Senator Charles E. Grassley—Republican-Iowa—the ranking member of the Senate Finance Committee is looking at consulting fees Keller received from drug companies for his research on the antidepressant <"">Paxil.  Meanwhile, Alison Bass, a former Globe reporter who wrote a book on Keller’s research and the legal trial and fallout, said the move was a long time coming.  Keller has never been publicly disciplined or sanctioned for his role in a study that hid the negative consequences of Paxil while promoting only positive outcomes.  Despite this, “he is still chief of psychiatry [at Brown] and pulling in millions of dollars in research funding from the drug companies and federal research agencies,” Bass said.

Studies have shown that researchers paid by a company are more likely to report positive findings when evaluating that company’s drugs. The private deals can directly affect patient care, said Dr. William Niederhut, a psychiatrist in private practice in Denver who receives no industry money.

Recently we reported that Grassley was demanding the American Psychiatric Association provide an accounting of its financing.  “I have come to understand that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions,” Grassley said in a letter to the association.  In 2006, the latest year for which numbers are available, the drug industry accounted for about 30 percent of the association’s $62.5 million in financing, with half that money going to drug advertisements in psychiatric journals and exhibits at the annual meeting; the remainder sponsored fellowships, conferences, and industry symposiums at the annual meeting.

Dr. Alan F. Schatzberg of Stanford and the association’s president-elect has $4.8 million stock holdings in a drug development company.  Dr. Melissa P. Dobell of the University of Cincinnati reportedly worked for eight drug makers and told university officials that from 2005 to 2007 she earned about $100,000 in outside income.  Meanwhile, AstraZeneca told Grassley it paid DelBello over $238,000 in that period, making some of those payments through MSZ Associates, an Ohio corporation DelBello established for “personal financial purposes.”  In June, Grassley reported to Congress that Dr. Joseph Biederman, a renowned child psychiatrist at Harvard Medical School, and a colleague, Dr. Timothy E. Wilens, reported to university officials earning several hundred thousand dollars apiece in consulting fees from drug makers from 2000 to 2007.  They actually earned at least $1.6 million each.  Another Harvard group member, Dr. Thomas Spencer, reported earning at least $1 million after being pressed by Grassley’s investigators.

A Vermont study found that on average, psychiatrists who received at least $5,000 from makers of newer-generation antipsychotic drugs appear to have written three times as many prescriptions to children for the drugs as psychiatrists who received less or no funding.  The drugs prescribed are not approved for most uses in children, who appear to be especially susceptible to the side effects.

A spokesman for Grassley’s office said the senator is looking into 30 physicians from up to 20 universities, but wouldn’t comment on any specific doctors.

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