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Harvard-Prudential Deal Raises Question of Conflicts

'Groundbreaking' Agreement With Major Insurer Permits Mixing of Academic, Corporate Interests.

The recent research agreement between Harvard Medical School and the Prudential Insurance Company may break new ground in the study of managed health care, but the pact also raises questions about the mixing of business and research.

Harvard professors downplayed the potential for conflicts in interviews yesterday. They said that although the collaboration could cause problems, the arrangement is not out of the ordinary.

According to an agreement reached recently between Prudential and Harvard, the insurance company will give the University $100,000 a year for the next three years for its research assistance.

"I don't see anything unusual about this, "said Lynn M. Peterson, director of the division of medical ethics at the Harvard Medical School. "It happens at every university in the country and the world."

The agreement also makes sense for Harvard, Peterson said, as the Medical School has long-established expertise in the field of health care.

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"Harvard has had a long history of looking at the quality of health care, long before [President] Clinton came aboard," Peterson said. "Explicitly, it goes back at least to the early '80s. They've been doing lots of studies to look at the effectiveness and the use-fulness of health care treatment."

The agreement with Prudential is one of a series of recent accords reached between the Medical School and private companies.

In the boldest such move, the Medical School recently launched an effort to court biotechnology companies for the new Harvard Institutes of Medicine. At the institutes. Harvard researchers will work directly with the companies to produce marketable drugs and other products.

Critics of agreements between academia and the corporate world have charged that outside money forces researchers to pursue only subjects that benefit business interests.

But a Prudential spokesperson said yesterday that the ties between the insurance company and the Medical School will not impose limits on Harvard researcher's ability to publish.

"There's certainly nothing in our agreement that would constrain research," said Roseanne Waters, director of operations for the Prudential Center for Health Research.

One professor, though, did say he was concerned about the more general problem of a conflict of interest between medical and corporate aims.

"As a researcher who's accepting money from aprivate company, one has to make sure that one isnot biased by the source of the funding," said Dr.Allan S. Brett, a member of the division of ethicsand an assistant professor of medicine at theHarvard Medical School.

"Speaking generally, a lot of research atHarvard Medical School is funded by privateconcerns," Brett said. "Certainly, drug Companiesare the perfect example, funding clinicians andinvestigating doing studies of new drugs.

The drug company will give the grant and theclinician will do the study. There's always aquestion when that happens."

And some ethicists have expressed fears thatuniversities could be complicit in the unethicalpractices of some companies. For example,Prudential's securities division is beinginvestigated by the federal government forimproper licensing, according to a story inyesterday's New York Times.

Waters, the Prudential spokesperson, called hercompany's agreement "ground-breaking."

"We believe this collaboration is the first ofits kind between an academic department and anational insurer-based managed care company,"Waters said.

"We think that health care organizations likePrudential have an increasing responsibility toevaluate what does work and what doesn't work,"Waters said. "We're a leader in this."

Prudential is looking at many different healthcare topics, said a Prudential staff member.

"They've got a number of research projectsunderway," said Diana Lipps, a public relationsconsultant for Prudential. "They're looking atprenatal care, angina, asthma treatments andsmoking cessation, among others.

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