Courting Tobacco Money

We have posted about the controversies arising from recently revealed research agreements between Richmond, Virginia based Virginia Commonwealth University (VCU) and tobacco company Philip Morris. These were first publicly discussed in May in a New York Times article. As we posted here, the main issues were that the research agreements themselves were secret; the agreements apparently gave Philip Morris control over all publications arising from the research, since they defined all products of the work as proprietary information belonging to Philip Morris; and that research for hire on behalf of a tobacco company, given that tobacco products have known severe health risks and no health benefits, seems to go against the mission of a medical school and academic medical center. We also noted that the university administration's apparent lack of qualms about its relationship with Philip Morris might have been related to its president's role as a leader of a tobacco company. (He sits on the board of Universal Corp, a tobacco buyer, processor, and distributor.) We later observed how little attention this subject has gotten in Richmond's major news outlet. Most recently, we noted that some university leaders were willing to open a public dialogue about the issue, thus exhibiting more transparency under criticism than has been shown by many other organizations.

This week's Richmond (VA) Style Weekly reported that there were plans for even greater ties between VCU and Philip Morris,

Virginia Commonwealth University officials have repeatedly denied the existence of a proposal to create a women’s health center funded by Philip Morris USA, but a draft copy of the proposal shows the idea did — and in some iteration still does — exist.

A copy of a working paper titled 'Proposal to Create the VCU Center for Health Pregnancy and Neonatal Outcomes,' obtained by Style Weekly, shows plans for a center focused on treatment and research into preventing defects, early birth and mortality.

Furthermore, it appeared that VCU leadership, not Philip Morris, initiated these plans,

In part, the memo obtained by Style reveals a plan for how VCU could solicit money from Philip Morris.

The seven-page proposal includes various attachments and is detailed down to budget projections for such specifics as bus and cab fare for participants. It concludes with a subheading titled 'Why Philip Morris USA should support this initiative.' The rationale for the pitch? 'Philip Morris USA will be investing in the future of the Richmond community,' and 'giving new meaning to ‘being well-born’.'

Pam Lepley, a university spokeswoman, says she was unaware of the proposal until contacted about it last week. During a July 16 community forum held on the medical campus, Dr. Francis L. Macrina, the school’s vice president for research, repeatedly denied knowledge of the proposal, saying that no proposal has ever existed.

Lepley now says the proposal is a working paper developed by the dean of the medical school, Jerry Strauss, but adds that it was not specifically aimed at attracting the financial support of Philip Morris.

'This is a draft proposal that Jerry Strauss was working on for any number of potential philanthropic providers,' Lepley says, calling it a working proposal that remains internal to the school. 'This is an initiative of Jerry Strauss’.'

The Richmond-based tobacco company is the only private corporation mentioned in the proposal and the only entity mentioned that is not the university or one of various governmental service providers foreseen as partners.

The assertion that the proposal has yet to see the light may not be worth a pack of smokes, either.

'This was a proposal that the dean of medicine shopped with Philip Morris,' says a medical school faculty member, speaking on condition of anonymity. 'Since all this has broken, [Strauss] has said [in meetings] that Philip Morris did not accept it or they did not fund it.'

We have previously discussed how medical school and academic medical center leaders often seem to care more about financial goals than the fulfillment of their clinical and academic missions. This can lead to pressure on faculty to raise research money from commercial sponsors, such as drug, biotechnology and device companies who have vested interests in having the research results favor their products. Medical schools and academic medical centers often seem so eager to get such money that they let the research sponsors control many aspects of the research, making it easier for them to manipulate the research to favor their products (see post here). Faculty pushed to work with commercial sponsors may be prone to become "key opinion leaders" who help the sponsors market their products.

All that is bad enough, but at least drug, biotechnology and device companies make products designed to treat, prevent, and sometimes even cure disease. In my humble opinion, medical school leaders fundamentally violate their institution's mission when they solicit money from a company whose products cause disease without providing any clinical benefits.