Leaders of teaching hospitals have close ties to drug companies, study shows

Nearly every large drug maker based in the US had at least one academic medical centre official on its board, raising questions about their independence

Pharmaceutical company payments to doctors extend far beyond rank-and-file clinicians — and deep into the leadership of America’s teaching hospitals, according to a study published today in the Journal of the American Medical Association.

A team of researchers at the University of Pittsburgh Medical Center examined the boards of the 50 largest drug companies by global sales (excluding three companies that were not publicly traded). The researchers found that 40 percent — 19 companies — had at least one board member who also held a leadership role at an academic medical center. Sixteen of the 17 companies based in the United States had at least one. Several had more than one.

All told, the research team found that 41 of the companies’ 2012 board members held leadership positions at academic medical centers. Six of the 41 were pharmaceutical company executives who served on hospital boards of directors or held other leadership posts.

Excluding the industry executives, the academics earned an average of nearly $313,000 that year for their board service.

ProPublica has been chronicling conflicts of interest in medicine for several years by looking at drug makers’ payments to individual medical practitioners for consulting, speaking and more. Our Dollars for Docs database currently collects information on payments by 15 companies that publicly report them, most as a condition of lawsuit settlements with the federal government.

Beginning this fall, under a provision of the 2010 Affordable Care Act, all pharmaceutical and medical device companies will have to publicly report payments to physicians. The first report is expected to be released in September and will cover payments made from August to December 2013.

In the study published today, the authors wrote that when academic medical leaders serve on pharmaceutical company boards, it can lead to conflicts not only for individuals, but for the critically important health care institutions they guide.

As board members of drug companies, academic leaders take on a fiduciary duty to those companies’ success. That can “conflict or compete” with their other responsibilities, the study says.

“Given the magnitude of competing priorities between academic institutions and pharmaceutical companies, dual leadership roles cannot simply be managed by internal disclosure,” the authors conclude. “These relationships present potentially far-reaching consequences beyond those created when individual physicians consult with industry or receive gifts.”

Among the academic leaders serving as drug-company board members was the dean of the University of Illinois College of Medicine, whose institution was criticized recently when members of its surgery department appeared in an ad for the daVinci surgical robot.




Sensex, Nifty may give up some gains: Tuesday closing report

Close below 6,675 may pull Nifty further lower

We mentioned in Monday’s closing report that the upmove of both the BSE 30-share Sensex and NSE 50-share Nifty may slow down. The benchmark opened Tuesday higher and immediately hit its all time high. The momentum was soon lost with both the indices plunging in the red. However, it came back into the green and closed higher.


Sensex opened at 22,455 and hit a high at 22,486 while Nifty opened at 6,730 and hit a high at 6,732. The Indices hit a low at 22,296 and 6,675. Sensex closed 22,446 (up 60 points or 0.27%) while Nifty ended the day at 6,721 (up 17 points or 0.25%). The NSE recorded a lower volume of 76.74 crore shares.

 Among the other indices on the NSE, the top five gainers were I T (1.52%), Media (1.37%), Energy (1.16%), Commodities (0.47%) and Pharma (0.41%). The top five losers were Bank Nifty (1.21%), P S U Bank (0.90%), Realty (0.90%), Finance (0.85%) and M N C (0.53%)
Of the 50 stocks on the Nifty, 25 ended in the green. The top five gainers were Wipro (3.46%), Cairn (3.35%), Power Grid (2.81%), Bank of Baroda (2.12%) and H C L Technologies (1.98%). The top five losers were B P C L (3.09%), Hindalco (2.72%), Kotak Bank (2.31%), Maruti (2.27%) and Asian Paints (2.14%).
Of the 1,534 companies on the NSE, 841 closed in the green, 602 closed in the red while 91 closed flat.


The market was awaiting the Reserve Bank of India (RBI) monetary policy review. The RBI kept its main lending rate -- the repo rate -- unchanged at 8% in line with market expectations. The central bank also left the cash reserve ratio, or the minimum percentage of deposits that lenders must park with the RBI, unchanged at 4%.


Meanwhile, the Election Commission (EC) has allowed Reserve Bank of India (RBI) to take action on new banking license as 'appropriate'. "RBI can go ahead with in- principle nod for banking licences," the EC said.


Coming back to markets, two of the software stocks in the pack of Sensex stocks were the top gainers today. Wipro rose 3.30% to close at Rs560.50 on the BSE while TCS rose 2.08% to close at Rs2,172.45.


Maruti was among the top five losers in the pack of Sensex 30 stocks. Maruti Suzuki has seen its passenger car sales inch up by 3.4% during 2013-14 financial year though its total sales, including exports, declined 1.4%during 2013-14 FY compared to the previous fiscal. The company has recorded a 6.4% drop in passenger car sales during March 2014 and its total sales fell 5.5% in March this year compared to the same month last year. Maruti fell 2.04% to close at Rs1,931.15 on the BSE.


Retail inflation measured by the consumer price index (CPI) moderated for the third month in succession in February 2014, driven lower by the sharp disinflation in food prices, although prices of fruits, milk and products have started to firm up. Excluding food and fuel, however, retail inflation remained sticky at around 8%. This suggests that some demand pressures are still at play, the RBI said. Since December 2013, the sharper than expected disinflation in vegetable prices has enabled a sizable fall in headline inflation. Looking ahead, vegetable prices have entered their seasonal trough and further softening is unlikely, the RBI said.


Indian manufacturing activity grew at a slower pace in March as weaker domestic demand dragged on output growth, a business survey showed on Tuesday. The HSBC Manufacturing Purchasing Managers' Index (PMI), which gauges business activity in Indian factories but not its utilities, fell to 51.3 in March after surging to a one-year high of 52.5 in February.


The Bharatiya Janata Party (BJP) on Monday said that if it wins national elections set to begin next week, its first priority would be to revive investment in the country's slowing economy. The BJP's prime ministerial candidate, Narendra Modi, has campaigned on pledges to spur development, create jobs and boost manufacturing.


In overseas markets, US indices closed Monday in positive.


Except for KLSE Composite (down 0.08%), Nikkei 225 (down 0.24%) and NZSE 50 (down 0.34%) all the other Asian indices closed in the positive. Jakarta Composite (2.22%) was the top gainer.


China's official Purchasing Managers' Index (PMI) increased to 50.3 in March from February's 50.2. A separate PMI HSBC Holdings Plc and Markit Economics pointed to weakness in the world's second-biggest economy. Chinese Purchasing Managers' Index fell to 48 in March, the lowest reading since July, from 48.5, HSBC Holdings Plc and Markit Economics said on Tuesday.


European indices were trading in the positive. US Futures were trading marginally higher.


Election Commission allows RBI to issue new bank licenses

Affirming the stand taken by RBI governor, the EC allowed the central bank to take appropriate action on issuing new bank licenses

The Election Commission (EC) has allowed Reserve Bank of India (RBI) to take action on new banking license as 'appropriate'. "RBI can go ahead with in- principle nod for banking licences," the EC said.


Earlier in the day, affirming that the grant of new bank licences is a regulatory process and not political, RBI governor Raghuram Rajan had said the central bank sought the EC's nod only to shield the announcement from any political controversy.


"This (giving bank licences) is not in any way a political process. It is an economic and regulatory process and therefore seen as distant and different...We have to undertake what we have to undertake," he said in response to objections raised by the BJP with regard to awarding bank licences when the election process is on.


"I think one should respect all the (political) opinions that are expressed," he added.


The process to award new bank licences was initiated in 2011 and it has spilled over to the election season because the due diligence process took a little longer, he said, adding, "All regulatory processes have to come to an end."


He said "this process has been taking place under its own steam. It is a regulatory process. It is not a governmental process and the notion of asking the EC was primarily because this is election season and we did not want the potential licensees to get their approvals under a cloud."


The EC is yet to decide on RBI's request to grant new licences during the election season. There are 25 applicants in the fray for new bank licences.


The model code of conduct came into force on 5th March with the announcement of the Lok Sabha election schedule. Voting will be held over nine days starting on 7th April and ending on 12th May with counting on 16th May.


"Once they (EC) say there is no issue there, they (RBI) would be in a position to announce the bank licences very quickly after taking it to the committee of the central board," he said.


On the issue of differentiated bank licences as well as on-tap licences, Rajan said, "The point is we should not be giving licences every 10 years and I also think that there is scope for having people with partial licences, for example, only for payments, lending, to come into the system.


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