Pharma Reform

I have tried to come up with  ways for Stanford to have accepted the Pfizer grant without raising concerns for potentially compromising the integrity of the programs or perceived conflicts and potential influence despite the assurances to the contrary.  Clearly the size of the grant makes it notable and more troubling.  I wonder if Stanford would have been as receptive of a $10,000 grant.  I also wondered why Stanford was chosen by Pfizer and not several other Medical Schools, some that might need the funding more than Stanford.  I  struggled to come up with options.  Maybe I’m just not creative enough.  Here are some of the options I considered for Stanford:

1)      Turn it down outright (consistent with their previously stated concerns and philosophy).

2)      Accept

a.  Accept as they did but now ensure Pfizer gets no additional exposure and absolutely has no influence on programming. How do you do that without complying with full disclosure requirements or ongoing continued contact with Pfizer personnel?

b. Accept with understanding that no Pfizer personnel or agent will have any contact with Stanford School of Medicine personnel, staff, or faculty now that the grant has been made.  This would include representative calls on healthcare providers; even by appointment (will Pfizer representatives now have preferential access?) Also, remove the milestone payments which in itself projects and implies the potential for Pfizer influence on continuing the programs or not, depending on what they like or don’t like about past programs.

c.  Accept as a part of a pool of equal shares of funding from multiple pharmaceutical companies. Lower the financial threshold to a point where most companies could participate and thereby also dilute the potential influence and exposure of any one company on programs.

d.  Similar to c. above, insist that the funding come from multiple companies with a non-profit type organization which doesn’t specifically identify individual contributors in advertising.  “Sponsored by an educational grant from MutliPharma interest in CME credibility.”  I’m not exactly sure how this could work for full disclosure without identifying contributors to “MultiPharma…”

I completely understand how ridiculous some of these “accept” options sound.  Option 2c could work and this has been done for years at medical meetings and conferences.  None of the accept options feels right or different from what has been done or tried in the past and that is why option #1 was probably the decision that should have been made.  Surely, for such a worthy cause, Stanford must have other sources for financing CME, even the technology advances in CME as proposed.

mike@pharmareform.com