Tuesday, July 14, 2009

ACRE: Academics Craving Reimbursement for Everything


Everybody’s buzzing about the new organization and website, ACRE, whose purpose is to stem the tide of legislation that is rehabilitating the ethics of physicians.

The trouble is, there is some confusion about which is the true ACRE website. Is it this one, which calls itself the "Association of Clinical Researchers and Educators"? Or is it this one, which calls itself "Academics Craving Reimbursement for Everything"? It's devilishly hard to distinguish the two, because their messages are identical.

At any rate, either ACRE 1 or Acre 2 is hosting this fancy conference to convince everyone that doctors should be giving more, rather than fewer, promotional talks for drug companies. Incredibly enough, one of the scheduled speakers is Dr. Jeffrey Flier, the dean of Harvard Medical School. I guess we now know where Dr. Flier stands on the issue!

17 comments:

Anonymous said...

Don't know what looks fancy about it. It's being held in a hospital amphitheater and the hotel is a Best Western.

It only costs $25 for healthcare professionals and is free for the press - either way it wouldn't cost you much. Maybe you should attend and report back. Or learn something?

Daniel Carlat, M.D. said...

Let's see...conference taking place at the crown jewel hospital of the best medical school in the world...the dean of the medical school is a speaker...drug industry employees pay $500/head to get in...sounds fancier than your average conference to me.

But, indeed, I have already paid my $25 fee and I will be there July 23!

Doug Bremner said...

Maybe they can all drink the cool aid together as a last gesture of love and devotion. Who made up the spoof web site? Hilarious!

Marilyn Mann said...

I thought this post by Pharma Giles was pretty funny:

http://pharmagossip.blogspot.com/2009/07/pharma-giles-writes.html

Anonymous said...

This is like a remake of "Thank You for Smoking" with Thomas Stossel playing Nick Naylor.

----------------------------

Stossel Jr.: You're The Sultan of Spin!
Thomas Stossel: "The Sultan of Spin"?
Joey Naylor: Mom reads to Carlat Psychiatry blog.

Lydia said...

I guess organizations like Prescription Project and American Medical Students Association have been so successful at bringing academic COIs to the forefront, that industry feels the need to respond. Wonder if a PR firm, drug industry trade association or medical communications firm came up with the idea? Also, congrats for getting on the Top Blog Healthcare List. I was really happy to see that.

CL Psych said...

We'll all be expecting a full report, Dr. Carlat. Perhaps the proceedings can be recorded so that we can all learn of how industry can help improving patient care. Like how we can get more soccer moms on Seroquel or Zyprexa.

And the spoof site is utterly hilarious!

Anonymous said...

Glad you're attending and looking forward to your reflections - and loved your unpacking of ACRE.

My "Better Living Through Modern Chemistry" T-shirt is in the wash so I can't attend.

In addition to Dr. Flier's appearance, this event was also advertised under his name on the Clinical Translational Science Institute/Harvard Catalyst e-list; "The following notice comes to you at the request of Harvard Medical School Dean Jeffrey Flier, M.D." This was under the subject heading "A special announcement from Dean Flier - The ACRE Charter Meeting & Conference." Nuf sed.

WD said...

Under mounting pressure from interest groups, the media, and select government officials, academic medical centers have begun adopting restrictive conflict of interest policies that often sever productive relationships between industry and physicians involved in clinical research and educational outreach.

I applaud people who are involved in these controversies to get together and discuss how to proceed to maximize the benefits for all, patients, physicians and companies. Their products have helped give so many people back real lives they never would have had without these physicians and pharmas.

There is a growing bitterness from patients for whom these medications have helped so much. The vilifying and personal attacks on physicians and pharmas doing their best to help people stopped being rational a long time ago.

Bernard Carroll said...

WD, you quoted the following from the (real) ACRE homepage: “Under mounting pressure from interest groups, the media, and select government officials, academic medical centers have begun adopting restrictive conflict of interest policies that often sever productive relationships between industry and physicians involved in clinical research and educational outreach.”

Will you please name some examples of "productive relationships" that were "severed" as a result of the recently increased scrutiny of conflict of interest? Do you have in mind Nemeroff’s undisclosed pimping for Glaxo and Janssen and Cyberonics, or Schatzberg’s pimping for Lilly and his own company Corcept, or Kuklo’s pimping for Medtronic, or Martin Keller’s pimping for Glaxo in Study 329? Do you call these “productive relationships”? Seriously, where is the negative fallout that Stossel whines about?

Isn’t it interesting that none of these operators who have been fingered by Grassley will be appearing on the ACRE program?

Peter Parry said...

Perhaps ACRE could supply all delegates with a copy of the Seroquel Global Product Team email for Pharma interactions with Investigator Initiated Trials (academic researchers) in their conference bags. It neatly summarises the relationship and benefits to industry and "rewards" to researchers. Seems spot on.

You can find a copy of this precious little document towards bottom of webpage: http://www.healthyskepticism.org/documents/Antipsychotics.php

The paper by Richard Smith (also linked) with his 25 years as editor at the BMJ puts it all in context.

WD said...

I believe in the free market. If the government or professional organizations require laws to protect a country's citizens they are perfectly within their right.

I have no issue with that.

But that is simply a cover screen for people here who are indignant over the fact these players make so much money for their work.

Two completely separate issues that are conflated to personally bash and push your little agendas.

People have the right to be compensated for their work according to what its worth is considered by the person paying it.

That's all. Pretty straightforward stuff.

insider said...

Both are fake!

Roy M. Poses MD said...

WD - the amount paid to bribe a politician may seem like a fair amount to both the payer and the recipient. Just the fact that the two parties involved in the transaction think the price is fair doesn't make the transaction ethical, or legal.

Transparency International defines corruption as "abuse of entrusted power for private gain." Most people trust medical academics to teach and do research without bias for or against particular companies or products. An academic who gets tens or hundreds of thousands of dollars to give talks favorable to a drug company's product may think the price is fair, and the drug company may think it is a fair amount to pay for marketing. MD, can you explain why that transaction is not corrupt?

R. W. Donnell said...

Dr. Carlat,
You said:
Everybody’s buzzing about the new organization and website, ACRE, whose purpose is to stem the tide of legislation that is rehabilitating the ethics of physicians.

Legislation is rehabilitating the ethics of physicians? You're joking aren't you?

Anonymous said...

WD, you write that "I believe in the free market." - as if such a thing exists. What planet does this "free market" you believe in reside on? Planet Vulcan? Have you not been paying attention to the last couple of years as the American and World economy have totally melted down due to your "free markets." If by "free" you mean manipulation by the monied and powerful, then I guess we are in agreement.

Changing tacks, I wholeheartedly concur with the esteemed Dr. Bremner - the spoof site is hilarious!

Peter Parry said...

the completion of the link in my previous comment above is:

hotics.php

i.e. full link:
http://www.
healthyskepticism.org/documents/
Antipsychotics.php

scroll to bottom of the webpage,
click on "AstraZeneca correspondence on Investigator Initiated Trials",
after reading that return to main webpage and then take link to Richard Smith (former chief editor BMJ)'s paper in PLoS Medicine.

"WD" you in particular may find these illuminating.

when very senior colleagues say they no longer trust any drug trial in any journal - you know there is a total crisis of trust in the academic literature - that's why things must change.

there's plenty of recommendations going around. Richard Smith's seem the clearest - journals stop publishing papers from drug trial researchers, drug trial researchers publish all protocols and raw data, other academics independently appraise and submit to journals for publication.

now that is simple and straightforward - and trust in medical science could be restored.