(NaturalNews) A congressional investigation has revealed
that a group of Harvard psychiatrists, instrumental in
pushing the diagnosis of bipolar disorder in children
and its off-label treatment with antipsychotics,
concealed from university officials the millions of
dollars they earned in consulting fees for the companies
that make those drugs.
Iowa Sen. Charles E.
Grassley requested the financial disclosure reports that
Drs. Joseph Biederman, Timothy E. Wilens and Thomas
Spencer had filed with Harvard University between 2000
and 2007. He then asked a handful of
pharmaceutical companies for their own records on
how much had been paid to the researchers in that time.
The numbers reported by the
drug companies were much higher than those on the
researchers' forms.
"Basically, these forms were
a mess," Grassley said. "Over the last seven years, it
looked like they had taken a couple hundred thousand
dollars."
Upon being confronted with the
discrepancies, the researchers admitted to having
concealed certain consulting fees and upped their
estimates. These new numbers still fell short of those
reported by the drug companies.
Biederman, for
example, originally told Harvard that he had received no
money from Johnson & Johnson in 2001. When Grassley
asked him to double check, Biederman admitted to
receiving $3,500. The drug company's records, however,
recorded payments of $58,169 to Biederman in that year
alone.
A more thorough investigation revealed
that Biederman and Wilens had received at least $1.6
million from the pharmaceutical industry between 2000
and 2007, while Spencer had received at least $1
million.
The researchers' concealment may have
violated both university and federal
conflict-of-interest rules.
The National
Institutes of Health (
NIH)
requires researchers who are receiving federal money to
report any earnings of $10,000 or more per year from a
single source. This information is reported to the
researchers' university, which is then responsible for
dealing with potential conflict of interests. The NIH
expects universities to take this on because it would be
logistically impossible for the agency to do directly.
The NIH gave out a total of $23 billion in grants in
2007, distributed among more than 325,000 researchers at
more than 3,000 universities.
But federal and
university officials admit that they have no way to
check the accuracy of the reported numbers.
"It's
really been an honor system thing," said Yale School of
Medicine Dean Robert Alpern. "If somebody tells us that
a pharmaceutical company pays them $80,000 a year, I
don't even know how to check on that."
Each
university has different rules to avoid conflicts of
interest. Some of them require that study participants
be alerted that researchers have received money from the
makers of the drug being studied, for example. In 2000,
Harvard banned researchers from testing any drugs made
by companies that had paid them more than $10,000 in a
single year.
In that year, Biederman told Harvard
that he had been paid less than $10,000 by Eli Lilly,
when in fact he had received more than $14,000. This
allowed him to conduct a study of Lilly's attention
deficit disorder drug Strattera in children, using money
from an NIH grant.
"The information released by
Sen. Grassley suggests that, in certain instances, each
doctor may have failed to disclose outside income from
pharmaceutical companies and other entities that should
have been disclosed," Harvard spokesperson Alyssa
Kneller said.
According to Kneller, a Harvard
university conflict committee is reviewing the
professors' cases. The NIH is also investigating.
"If there have been violations of NIH policy, and if
research integrity has been compromised, we will take
all the appropriate action within our power to hold
those responsible accountable," NIH spokesperson John
Burklow said. "This would be completely unacceptable
behavior, and NIH will not tolerate it."
Biederman and Wilens' NIH grants were administered by
Massachusetts General Hospital. If the
hospital is found to have been involved in the
doctors' violation of
conflict of interest rules, NIH could restrict or
suspend future grants. Massachusetts General Hospital
received $287 million worth of NIH grants in 2005.
Due to the widely acknowledged holes in university
and federal conflict-of-interest rules, a number of
states require pharmaceutical and medical device
companies to report all the money that they pay out to
researchers, and Grassley is leading an effort to
establish a national registry of such information. He
said that the recent revelations only underscore the
need for such a measure.
Yet the implications of
the Harvard scandal go far beyond conflict-of-interest
rules, because Biederman and colleagues have been
instrumental in the controversial trend to diagnose more
children with
bipolar disorder, and to treat those children with
antipsychotics designed for adults with
schizophrenia.
The diagnosis of pediatric bipolar
disorder increased by 40 times between 1994 and 2003.
Advocates of this diagnosis claim that it has a
different diagnostic profile than the adult
disease, with changes in mood occurring much more
rapidly. But many critics have questioned whether
pediatric bipolar disorder is even a real condition, or
whether it is being too widely diagnosed.
Adding
to the debate, the Harvard researchers have also pushed
for the aggressive treatment of the disease with
antipsychotics, which are not licensed for such a use.
The discovery that those same researchers concealed
massive payments from the drug industry has cast further
doubt on their motivations, and has led many to wonder
if too many children are now being diagnosed and treated
with potentially dangerous drugs.
There are no
long-term safety data on the effects of antipsychotics
in children, but the young are known to be more
susceptible to metabolic side effects and weight gain.
"[These researchers] have given the Harvard
imprimatur to this commercial experimentation on
children," said Vera Sharav, president of the Alliance
for Human Research Protection.
Sources for this
story include:
www.nytimes.com.