Donations tie drug firms and nonprofits

More on how pharmaceutical companies may be skewing the drug sales playing field through influence on the medical nonprofit specialty societies that are held in high regard by patients and clinicians alike:

Donations tie drug firms and nonprofits
By Thomas Ginsberg
Philadelphia Inquirer Staff Writer
Sun, May. 28, 2006
Many patient groups reveal few, if any, details on relationships with pharmaceutical donors.
The American Diabetes Association, a leading patient health group, privately enlisted an Eli Lilly & Co. executive to chart its growth strategy and write its slogan.

The National Alliance on Mental Illness, an outspoken patient advocate, lobbies for treatment programs that also benefit its drug-company donors.

The National Gaucher Foundation, a supporter of people suffering from a horrific rare disease, gets nearly all its revenue from one drugmaker, Genzyme Corp.

Although patients seldom know it, many patient groups and drug companies maintain close, multimillion-dollar relationships while disclosing limited or no details about the ties.

At a time when people are making more of their own health-care decisions, such coziness raises questions about the impartiality of groups that patients trust for unbiased information. It also poses a challenge for groups trying to hold patients' trust and still raise money to serve them. An Inquirer examination of six groups, each a leading advocate for patients in a disease area, found that the groups rarely disclose such ties when commenting or lobbying about donors' drugs. They also tend to be slower to publicize treatment problems than breakthroughs. And few openly questioned drug prices.

I agree with this assessment. While these groups perform an important function, especially in education and advice to patients, the covert involvement of industry in this sector seems inappropriate, even from the free-market viewpoint.

These organizations are not commercial and should not be used in any way as an avenue for increased drug advertising or "branding" with patients. The lack of disclosure mentioned in the Inquirer article is at the heart of the matter. Apologists who offer opinions that the money does not influence insiders at these organizations are deluding themselves.

Worse, the money seems to come not from R&D or the charitable arms of these drug companies but from marketing:

The donations are sometimes portrayed by the companies and nonprofits as "giving back" to patients. But the funding usually comes from the companies' marketing or sales divisions, not charity offices, company and nonprofit officials said. Grants often rise with promotional spending as a drug hits the market and fall when sales ebb.

Donations from Merck and Pfizer Inc. to the Arthritis Foundation more than doubled, to at least $1.65 million combined, in 2000 as they launched Vioxx and Celebrex. The donations fell below $375,000 by 2004, when safety fears had flattened sales, foundation reports show.

Merck explicitly wove the foundation into sales strategies. A 2001 internal memo, disclosed in product-liability trials, shows that Merck sought to use the foundation's pain-management program to "demonstrate additional benefits" of its products.

Practices like this at pharmas really teeter on the precipice of unethicality on the part of marketing. Merck, for example, had corporate values that asked employees to ask themselves "how would it appear in print?" as a step for evaluating the ethics of some planned action.

In this case, the Philadelphia Inquirer has just answered that question.

-- SS