Stanford University’s incoming president, Marc Tessier-Lavigne, has developed a career that successfully melds science, business and academia.
Although he is now coming off a stint as president of Rockefeller University in New York starting in 2011, his business connections are extensive.
A Genentech Executive
The NYT noted,
He may be best known, though, for his work at Genentech. As the No. 2 executive in research, he oversaw 1,400 scientists in one of the most innovative and successful companies in the biotech industry, known for the groundbreaking cancer drugs Avastin, Rituxan and Herceptin.
To expand that, his brief CV on the Rockefeller University website included,
1991 - 2001 increasingly senior faculty positions at UCSF
2001 - 2003 professor at Stanford
2003 - 2008 senior vice president, research drug discovery, Genentech Inc
2008 - 2009 exectuive vice president, research drug discovery, Genentech
2009 - 2011 chief scientific officer, Genentech
Member of Multiple Biotechnology Corporate Boards of Directors, Chairman of One
However, his involvement with the pharmaceutical and biotechnology industries hardly ends there. He currently is on four biotechnology corporate boards of directors. These include:
For which he received compensation of $374,926 in 2014, according to the 2015 proxy statement. His holdings in the company were then 130,122 shares.
Juno Therapeutics Inc
For which he received compensation of $30,000 in 2014, according to the 2015 proxy statement. His holdings in this company were then 175,000 shares Series A2 convertible preferred.
For which he received compensation of $1,764,032 in 2014, according to the 2015 proxy statement. His holdings in this compary were then 34,716 shares.
Pfizer, then Denali Therapeutics
Also, in 2011, he became a member of the board of directors of Pfizer, Inc. He left in 2015 when he co-founded, and became chairman of the board of a new biotechnology company, Denali Therapeutics. In 2014, according to the Pfizer 2015 proxy statement, he received compensation of $300,000. His holdings in the company then were 104 shares of stock, and 24,307 stock units.
He remains as chairman of the board of Denali, according to the company website. Since this company is privately held, I could not find any information about the compensation or holdings of board members.
To summarize, the incoming president of Stanford, on of the most prestigious American universities, one of the foremost US sites for biomedical research, and home to an equally prestigious medical school and academic health center, spent most of the last 15 years heavily involved with the pharmaceutical and biotechnology industries. He was a top Genentech executive for eight of those years, served as a director of the then biggest US pharmaceutical company, and currently is a member of the boards of directors of four biotechnology companies, and is chairman of one of them. He earned nearly $2.5 million dollars from these directorships in 2014, the last year for which such data is public, and owned hundreds of thousands of shares of stock in these companies.
How he had the time to executive all his fiduciary responsibilities as a director of four health care corporations while being the president of Rockefeller University, and apparently continuing to do his own research boggles the mind.
However, Stanford's incoming president is a perfect example of how health care is now run by an interlocking group of insiders who have personally profited massively from their situated influence.
So in whose interests will he act as president of Stanford? The New York Times cited those who hailed his scientific prowess.
According to Susan K. McConnell, a professor of biology at Stanford, Dr. Tessier-Lavigne was responsible for a 'long list of amazing discoveries' involving identifying molecules that guide the growth of nerve connections in the developing brain.
On the other hand, he had important affiliations with two biotechnology companies that were known for leading the charge for stratospheric drug prices as much as they were known for developing innovative drugs. By coincidence, or not, he was a top executive for the same company, Genentech, as was Dr Susan Desmond-Hellman, who later became the leader of the University of California - San Francisco. As we noted here, Dr Desmond-Hellman was a public defender of such pricing, in particular, of the then (2007) stratospheric $55,000 a year price of bevacizumab (Avastin).
Prof Tessier-Lavigne also is currently on the board of Regeneron, which became known for charging $1850 per montly dose of Eylea, a drug for macular degeneration, while paying its board members and executives proportionately large amounts. As we noted above, Professor Tessier-Lavigne got over $1.75 million in 2014 for his board service, and in 2014, the company's CEO received over $36 million.
In an interview with the NY Times, professor Tessier-Lavigne said,
We do have to ensure access [to Stanford], broadly, both in terms of access for people who are disadvantaged socioeconomically and, of course, diversity
But how easy would it be for a man with his biotechnology corporate connections and the riches they produced for him to step into the shoes of disadvantaged, diverse students (or patients)?
When asked about his corporate background, he told the NY Times,
that before taking the reins at Stanford in September, he will review all his corporate relationships with the board to determine whether any conflicts of interest exist.
That suggests doubt about the existence of such conflicts. But as we first wrote in 2006,
Medical schools and their academic medical centers and teaching hospitals must deal with all sorts of health care companies, drug and device manufacturers, information technology venders, managed care organizations and health insurers, etc, in the course of fulfilling their patient care, teaching, and research missions. Thus, it seems that service on the board of directors of a such public for-profit health care company would generate a severe conflict for an academic health care leader, because such service entails a fiduciary duty to uphold the interests of the company and its stockholders. Such a duty ought on its face to have a much more important effect on thinking and decision making than receiving a gift, or even being paid for research or consulting services. Furthermore, the financial rewards for service on a company board, which usually include directors' fees and stock options, are comparable to the most highly paid consulting positions. What supports the interests of the company, however, may not always be good for the medical school, academic medical center or teaching hospital.
Last year, Anderson et al documented the prevalence of such board level conflicts of interests, and wrote,(1)
previous guidelines have emphasized the relationships of clinicians and researchers with industry, but institutional conflicts of interest, which arise when administrators, including executive officers, trustees, and clinical leaders have a financial relationship with industry, are increasingly recognized and pose a unique set of risks to academic missions.
If Professor Tessier-Lavigne has doubts whether his current service on four biotechnology boards of directors, as chairman of one of these companies, as former board member of Pfizer, and as former executive of Genentech could create any conflicts of interest, the students, faculty, patients and alumni of Stanford should be very wary of what direction he will take their university.
As we have said again and again, the web of conflicts of interest that is pervasive in medicine and health care is now threatening to strangle medicine and health care. Furthermore, this web is now strong enough to have effectively transformed US health care into an oligarchy or plutocracy. Health care is effectively run by a relatively small group of people, mainly professional managers plus a few (lapsed?) health care professionals, who simultaneously run or influence multiple corporations and organizations.
For patients and the public to trust health care professionals and health care organizations, they need to know that these individuals and organizations are putting patients' and the public's health ahead of private gain. Health care professionals who care for patients, those who teach about medicine and health care, clinical researchers, and those who make medical and health care policy should do so free from conflicts of interest that might inhibit their abilities to put patients and the public's health first.
Health care professionals ought to make it their highest priority to ensure that the organizations for which they work, or with which they interact also put patients' and the public's health ahead of private gain, especially the private gain of the organizations' leaders and their cronies.
1. Anderson TS, Good CB, Gellad WF. Prevalence and compensation of academic leaders, professors and trustees on publicly trade US healthcare company boards of directors: cross sectional study. Brit Med J 2015; 351:h4826. Link here.