Wednesday, September 10, 2008

An "Unfashionable" Pitch for More Academic-Industry Collaboration

The Wall Street Journal Health Blog reported

Marc Feldmann and Ravinder Maini, scientists from the Kennedy Institute of Rheumatology at Imperial College London ... [were] feted by Johnson & Johnson for work that paved the way for drugs called TNF inhibitors, used to treat rheumatoid arthritis and other inflammatory diseases.

The scientists won the second Dr. Paul Janssen Award for Biomedical Research, which carries a $100,000 prize and honors a legendary drug researcher at J&J.

Feldmann took the opportunity to opine on health science policy, making a pitch for even more cooperation between biomedical science and pharmaceutical and biotechnology companies.

From the podium at the New York Academy of Sciences, Feldmann made the case for closer collaboration between the drug industry and academia, not exactly the fashionable thing to say these days. Science, he said, is meant to be original and novel, while medicine is conservative and needs to be safe. The melding of the two is necessary for medical progress, but the process for doing so is 'ill-defined' and 'difficult.'

More efficient academic-industry interactions, he argued, would help increase the success rate for translating lab work into real-life medicine. The hurdles in the development of a drug that eventually became Remicade spoke to this notion. He and his colleague Maini approached several companies with their research on TNF before Centocor, bought by J&J in 1999, took them seriously.

Feldman said scientists understand the course of disease and how to make the most of innovative clinical trial methods, while companies understand products, regulatory requirements and marketing. The knowledge and skills are complementary, he said, and can 'augment success' for development of new therapies.

It was not clear from the article whether Prof Feldmann was only talking about collaboration on bench research, but the examples above suggest he was also talking about clinical research. In that case, he did not address the downsides of too much entanglement between companies who want to sell products and academics who are supposed to pursue the truth. These downsides, frequently discussed on this blog, include manipulation and suppression of clinical research by firms seeking results favorable to their marketing goals.

Feldmann's advocacy of policies to increase academic-industry collaboration ought to be viewed in light of his own relationships with industry. A quick Google search revealed that he is on the scientific advisory boards of multiple biotechnology companies, including Nuon Therapeutics, Receptor BioLogix Inc (note that only a cached version of their relevant web-site is available at the moment), and Trillium Therapeutics. He is a consultant to the research programme of Genesis Research and Development Corporation (see page 10 of this annual report.) He was also on the Roche Bioscience Advisory Board.

In my humble opinion, those who advocate particular health policy positions have the same obligation to disclose relevant conflicts of interest as do those who advocate particular approaches to clinical problems. Policy positions ought to be skeptically evaluated taking into account whether those expressing them stand to gain personally from what they advocate. Failure to adequately disclose conflicts of interest ought to inspire even more skepticism.

I fear much that too much the health policy debate amounts to stealth health policy advocacy.

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