Charles Nemeroff, Unleashed

It looks like Dr. Charles Nemeroff has found a way to wriggle out of the already loose leash clapped around his neck by Emory University.

For those who have forgotten about Dr. Nemeroff’s recent trials and tribulations, here’s a brief recap. He was the principal investigator of a $3.95 million NIH grant to study several drugs by GlaxoSmithKline. But he was at the same time making hundreds of thousands of dollars doing promotional talks for the same company, orders of magnitude higher than the NIH maximum allowed. In order to skirt these regulations, Nemeroff simply lied to Emory officials. According to the New York Times, he signed a letter dated July 15, 2004, promising Emory that he would keep his earning from GlaxoSmithKline to less than $10,000 per year. But that same day, Nemeroff was at the Four Seasons Resort in Jackson Hole, Wyoming, where he was earning $3000 for a talk for GSK, part of $170,000 in income he earned from the company that year—17 times the figure that he had agreed to.

Emory removed him as department chair shortly thereafter, but inexplicably kept him on as full professor and allowed him to re-apply for more NIH grants within two years. Nemeroff’s public statement revealed an alarming lack of remorse: “I regret the failure of full disclosure on my part that has led me to the current situation. I believe that I was acting in good faith to comply with the rules as I understood them to be in effect at the time.” Translation: “I’m bummed out that this is happening to me. I didn’t do anything wrong.”

Meanwhile, Emory’s “punishment” still allows Nemeroff to take drug company money for promotional talks in the guise of ACCME accredited activities. According to Emory’s letter: “He will be limited to accepting payment for ACCME-accredited speaking engagements sponsored by academic institutions or professional societies.”

But Dr. Nemeroff has already found a way to escape from this restriction. In February, Dr. Nemeroff will co-chair this CME series supported by Bristol-Myers Squibb called “Measurement Based Care Strategies for Depression.”

It is “jointly sponsored” by the University of North Texas Health Science Center (UNTHSC) and an obscure outfit called “Letters & Sciences.” Letters & Sciences (L & S) is presumably a MECC but a Google search shows that they have no website. They are listed as being an “approved provider” of CE credit for nurses by both the New Jersey State Nurses Association (NJSNA) and the California Board of Registered Nursing.

It is clear that L & S is on a Bristol-Myers Squibb gravy train, making their money by producing promotional CME encouraging doctors to prescribe plenty of Abilify for bipolar disorder and depression. They teamed up with UNTHSC to produce this recent CME series as well, which presumably pushes the use of Abilify for kids.

By teaming up with this shadowy MECC, Nemeroff is complying with the letter of his punishment but is playing fast and loose with its spirit. In specifying that Nemeroff is limited to CME events “sponsored by academic institutions and professional societies,” Emory is asking that legitimate institutions create and control the content. But in this case, we see the usual CME shell game in which a private MECC is creating the content and is paying a nominal “co-sponsor” to provide CME credit.

If I were Senator Grassley, I’d be sending letters to L&S, UNTHSC, ACCME, Nemeroff, etc…, asking:

--How did L & S obtain the grant from BMS for this program?
--What is L & S? Where are they? Who is on their staff? Which medical writers are creating the content? How much money are they making from BMS? What percentage of their total income comes from events supported by BMS?
--What, exactly, is UNTHSC doing as “co-sponsor” of the event? Are they simply extracting a healthy fee from L & S, in return for a cursory review of their paperwork and disclosure forms? Or are they actually managing the event and producing content?

Leashes always chafe, especially when the wearer feels no guilt. Sometimes, however, loosening the leash is precisely the wrong thing to do.

Hat tip to Bernard Carroll.