CORRECTION APPENDED

A U.S. senator introduced legislation to up disclosure requirements for industry payments to doctors last Thursday, the latest salvo in a national debate over ties between academic medicine and industry that could affect politices at the Medical School and its many affiliates.

The bill, proposed by Senator Charles E. Grassley, a Republican from Iowa who has been an outspoken critic of such ties, would require public disclosure of industry payments over $100.

The legislation follows the passage of a similar law in Massachusetts this August that required the medical industry to publicly disclose gifts worth more than $50. The Grassley bill would make all research-related funding public as well.

Pharmaceutical industry ties have been a particularly hot issue at the Medical School this past year, prompting student protests last fall over the level of disclosure for professors receiving money from medical corporations, and bringing HMS national scrutiny this summer, when Grassley reported that psychiatrist Joseph Biederman of Harvard-affiliated Mass. General Hospital received $1.6 million in consulting and speaking fees from the makers of drugs he used to treat children for bipolar disorders.

Grassley later accused psychiatrists at Stanford and Emory of failing to disclose similar industry ties.

Jill Kozeny, the senator’s communications director, said Grassley’s goal is to create an open environment in medical school research and education.

“He wants it all on the table, to lay it all out, so we can make judgments,” she said.

Professors and researchers across the Medical School praised the legislation for its potential to bring transparency to the school. The issue, brought to the fore by the Biederman allegations, recently prompted HMS Dean Jeffrey S. Flier to announce this month that the school would reassess its conflict of interest policy, which has not been updated since 2004.

“Making the information public creates a constructive dialogue of the nature of relations of industry,” said Associate Professor Eric G. Campbell of Mass. General.

Campbell added that, despite the debate, disclosure is fast becoming universal, noting the new law in Massachusetts.

The Medical School will consider the state legislation when it convenes to revise its conflict of interest policy.

“Not supporting this is foolish,” Campbell said. “It’s a fact of life, and individual institutions should get used to it.”

Former New England Journal of Medicine editor Arnold S. Relman, who participated in the student protest last fall and is a long-time advocate of independence from industry in medical education, added that he supports the proposed legislation.

“When [Grassley] perceives that these financial interests are not fully disclosed and often not in the public interest, he steps in, and I say more power to him,” he said.

But some individuals had reservations about the new legislation.

David F. Torchiana, chairman and CEO of the Mass. General Physicians Organization, said that while he agrees with the legislation in general, he believes that some interaction with industry is necessary.

“If you don’t have a way to get that into commercial development, distribution, and sales, you are working a vacuum,” he said. “The medical, pharmaceutical, and device industry depends on us, and we depend on them.”

Torchiana added that there are many holes in the legislation’s details. [SEE CORRECTION BELOW]

According to Torchiana, Grassley’s bill does not require itemization of payments, so the public would not know the reason behind the industry relationship, which could be benign.  [SEE CORRECTION BELOW]

“The disclosures made to date from this kind of source raise as many questions as they answer,” he said. “They detail the kind of payment, but don’t say what it was for.”

There are also questions about whether the legislation will be able to make it through Congress.

Relman expressed doubts that the legislation would pass at the national level because of the strength of the pharmaceutical company lobby.

Nevertheless, he supports the legislation and the severing of most industry ties in general.

“Grassley says medical schools are supported by taxpayer money and we expect that money to be used in an appropriate way,” he said.

—Staff writer Laura G. Mirviss can be reached at lmirviss@fas.harvard.edu.

CORRECTION

The Jan. 28 News article, "Bill Aims To Increase Transparency," incorrectly stated that David F. Torchiana, chairman and CEO of the Mass. General Physicians Organization, had criticized a bill sponsored by Senator Charles E. Grassley for not requiring itemization of payments and for having holes in its provisions. In fact, Torchiana generally praised the bill and his comments about the potential pitfalls of industry disclosing payments to physicians was directed at recent instances of industry disclosure and not specifically at Grassley's legislation.