Johns Hopkins: The Most Trusted Name in ... Skin Care?

The Baltimore Sun and the Wall Street Journal reported (the latter available here via the Pittsburg Post-Gazette) the latest venture by the revered Johns Hopkins University. They are collaborating with a cosmetic company whose products will be labeled as produced "in consultation with Johns Hopkins Medicine."

The Cosmedicine "premium skin-care line," per the Journal, will be sold by Sephora, a unit of LVMH Moet Hennesy Louis Vuitton, and manufactured by Klinger Advanced Aesthetics, a unit of TrueYou.com Inc. According to Dr Edward Miller, Chief Executive of Johns Hopkins Medicine and Dean of the School of Medicine (and also on the board of directors of Bradmer Pharmaceuticals, a Canadian biotechnology company), "We have been pretty clear about our role. We are reporting on the scientific validity of studies done by outside testing agencies." But, according to the Journal, "Johns Hopkins will also work with Klinger to develop clinical 'best practices for the company's chain of spa-clinics." Their offerings include "'light medical' services, such as Botox and Restylane shots...."

The Cosmedicine web-page proclaims, "Cosmedicine, the only skincare line tested for performance and safety in clinical studies designed and analyzed in consultation with Johns Hopkins Medicine, a world leader in healthcare, education, and research."

The idea of the Johns Hopkins collaboration developed out of Klinger CEO Rich Rakowski's idea of developing products "through the lens of healthy skin and not anti-aging." The company "adopted what he calls a 'healing strategy' for its products." The company decided it wanted to offer products with "measurable" benefits, and then approached Johns Hopkins to help with the measurements. The Journal reported that Professor Frederick Brancati, Chief of the Division of General Internal Medicine, championed the collaboration, but had to work "to overcome significant faculty opposition."

Prof Brancati "and other officials declined to disclose the fees Johns Hopkins Medicine received from Klinger or to estimate how much revenue the venture may one day bring. Klinger, a unit of a publicly traded company, TrueYou.com, Inc., plans to give the institution a yet-to-be-determined equity stake." The Sun also reported that the University will get a "board seat."

According to the Journal, the motivation to work with Klinger was Hopkins' "need for funding the traditional research and teaching mission." Prof Brancati said, "that is what sold it for me and to the leaders of the institution. We have to be innovative and creative" The Sun reported that Brancati "hopes his division might get a six-figure sume from the deal to help fund its mission, which includes care for the poor."

The deal has drawn criticism now that it has been made public.

Product Endorsement (as a Mission Violation) - One issue is that Hopkins' role appears to be close to endorsement of a product. The Journal quoted Prof Arthur L Caplan of the University of Pennsylvania Department of Medical Ethics, "unless you have acute vision and a lot of time to read [the small print], this is going to look like a product endorsement." The Sun quoted Mildren Cho of Stanford Center for Biomedical Ethics, "what is the consumer supposed to take away from the fact that Hopkins' name is attached to this product?" The Sun also quoted Dr Amy Newburger, a practicing dermatologist, "this is a weapon of mass promotion. The university's name is going to be used to promote this [product] ... to the exclusion of other, perhaps more effective products that have not forged a relationship with the university." Unsaid here, but important is that the university appears to be endorsing a product in exchange for money, in apparent contrast with its academic mission to conduct free and honest inquiry. In contrast, the Sun quoted Rakowski, "they are not endorsing this product, nor have I asked them."

Conflict of Interest - Caplan also stated that it would be a conflict of interest to "study what you own." The Sun quoted Dr Marcia Angell, former editor of the New England Journal of Medicine, "you can't evaluate a product that's made by a manufacturer that's hired you. The thing is riddled with conflict of interest." Johns Hopkins Medical Dean Miller countered by saying that the Hopkins scientists who are examining Cosmedicine data do not personally own equity shares in the company that makes the product, although they do received consulting fees of an undisclosed size.

Irrelevance to Mission - Finally, the Sun quoted Dr Peter Lurie of Public Citizen Health Research Group charged, "it's an educational institution that's willing to completely stray from its true function, whic is to do education, research, and provide clinical services."

In my humble opinion, the criticisms are apt. It particularly saddens me that a division of general medicine within a wealthy university, whose budget is $2.4 billion, endowment, $1.695 billion, and hospital and health system revenue, $1.661 billion apparently feels so impoverished that it needs to help sell cosmetics to raise money to support its basic academic mission.