WASHINGTON—Next month five physicians will lead sessions at a National Institutes of Allergy and Infectious Diseases (NIAID) conference that was called to write clinical practice guidelines for preventing neonatal herpes. Four of those doctors have direct financial relationships with pharmaceutical giant GlaxoSmithKline—a company which stands to gain if the conference recommends broader testing of pregnant women for herpes, since Glaxo makes the antiviral drug Valtrex. Today more than 40 physicians and scientists and more than a dozen health organizations called on the National Institutes of Health (NIH) to seek balance when it convenes guideline-writing panels, and to ensure that all panelists are free from financial conflicts of interest like those of the four Glaxo-affiliated doctors.
A December 13 front-page article in The Wall Street Journal documented how Glaxo bankrolls continuing medical education sessions and physician talks aimed at promoting universal herpes screening for pregnant women. Remarkably, two of the doctors whose activities were exposed by the Journal will be among the five presenters at the upcoming February 20 NIH conference. The four presenters with ties to Glaxo are:
• Dr. Anna Wald of the University of Washington has received grants and research support for her work on herpes from Glaxo and Roche, and received honoraria from Novartis, all of whom make antiviral drugs for herpes;
• Dr. Zane Brown of the University of Washington gives “two to three lectures a week advocating universal herpes testing for pregnant women, earning $1,000 to $2,500 per talk,” and most of those sessions were financed by Glaxo grants to the CME providers, according to the Journal article;
• Dr. Laura Riley of Harvard Medical School is secretary/treasurer of the American Herpes Foundation, a “patient advocacy” non-profit run by a for-profit medical marketing firm; its board contains no patients and its $183,000 budget in 2004 was almost entirely funded by Glaxo and Roche; and
• Dr. Richard Whitley of the University of Alabama at Birmingham, who serves on the speakers bureaus for Glaxo and Novartis and serves on the board, and receives stock options and compensation from the start-up firm Fermavir, which is developing next-generation drugs aimed at the herpes family of viruses. Moreover, Dr. Whitley carried out these private sector activities while running NIAID’s Collaborative Antiviral Study Group.
Obstetricians and gynecologists are sharply divided over whether all pregnant women should be tested for herpes, given that neonatal transmission of herpes is relatively rare, occurring in as few as 200 or as many as 1,250 U.S. births each year, according to sources quoted in the Journal. Articles and letters questioning universal testing, which would almost surely lead to more women being prescribed Valtrex, have recently appeared in the Lancet and leading OB/GYN journals.
“Given the controversy surrounding the subject, we were surprised to see the lineup of speakers for the February 20 meeting… The lineup did not reflect the diversity of views on this subject, nor did the invitation reveal the conflicts of interest of virtually every invited presenter,” the health organizations and physicians wrote to Dr. Elias Zerhouni, director of the National Institutes of Health, Dr. Anthony Fauci, director of the NIAID, which is part of NIH, and other officials. Signatories included Lancet Editor-in-Chief Dr. Richard Horton, former New England Journal of Medicine editors Dr. Marcia Angell and Dr. Jerome P. Kassirer, the Center for Medical Consumers, Consumers Union, and the National Women’s Health Network.
This isn’t the first time that NIH has convened guideline-writing panels that had members with ties to companies that stand to lose or gain from the panels’ recommendations, according to the Center for Science in the Public Interest, which organized the letter to NIH. Panels having to do with managing cholesterol, hypertension, and HIV/AIDS have all had large numbers of industry-funded researchers serving on them.
“NIH shouldn’t let drug company-affiliated doctors write the rules, and it shouldn’t stack the deck to make it look like there is medical consensus on something when there’s not,” said Merrill Goozner, director of the Integrity in Science Project at CSPI, which maintains a database of industry-funded scientists.For more information, contact: Center for Science in the Public Interest