A US Senator is questioning the financial ties between drug makers and members of a federal panel who recently criticized proposed guidelines to restrict opioid prescribing.
In a letter to the US Department of Health and Human Services, Senator Ron Wyden (D-Ore.) wrote that he has “a number of concerns” about several panel members who tried to “weaken efforts” by the US Centers for Disease Control and Prevention to issue its guidelines. There “appear to be personal and institutional conflicts of interest” involving some of those panelists, he explained.
The panel, which is known as the Interagency Pain Research Coordinating Committee, met two months ago to review the CDC guidelines for prescribing the painkillers. The guidelines call on doctors to prescribe opioids only after other therapies have failed as part of an effort to improve physician awareness of abuse problems, and to encourage greater monitoring. Wyden, by the way, sent a separate letter to the CDC endorsing the guidelines.
But the guidelines have drawn objections, notably from various organizations that accept funding from drug makers that market opioid painkillers, such as Purdue Pharma, which is best known for selling OxyContin. And representatives from some of these organizations, some of which describe themselves as patient advocacy groups, were among the nongovernmental panel members.
One panel member was Cindy Steinberg of the US Pain Foundation, which received more than $180,000 from drug companies in 2012, according to information on its web site that Wyden cited. Another was Penny Cowan of the American Chronic Pain Association, which receives financial backing from a dozen drug makers and one of its advisory board members is also a scientific member of the IPRCC.
Wyden also cited another nonpublic member of the panel, Myra Christopher of the Center for Practical Bioethics, where a $1.5 million endowed chair is supported by Purdue. As we reported previously, a Purdue spokesman has acknowledged the funding. We asked Christopher for comment. She said she had not yet seen the letter, but we will update with any additional reply that we receive.
Similarly, Dr. Richard Payne, a professor of medicine and divinity at Duke University’s Divinity School, is also an employee of the Center for Practical Bioethics. According to a federal data base cited by Wyden, Payne received approximately $6,700 in travel reimbursement and consulting fees from Purdue. We asked Payne for comment and will update you accordingly.
“These financial and professional relationships raise serious concerns about the objectivity of the panel’s members that deserve additional review,” Wyden wrote to the HHS. He also asked the agency to explain its oversight of the IPRCC panel, given that several members whose terms had expired were allowed to continue to serve and participate in the December meeting. An HHS spokeswoman wrote us that the agency will respond directly to Wyden.
One consumer advocate agreed. “These conflicted members should not have been allowed to participate in deliberations at the December meeting,” said Michael Carome, who heads Public Citizen Health Research Group. “Equally alarming is the failure of these members to disclose their conflicts of interest before these deliberations began. As a result of these failures, the IPRCC advisory process was corrupted.”
“This illuminates a threat to the CDC guidelines. Much of the opposition to the CDC guidelines comes from individuals or organizations who stand to … lose financially if CDC guidelines are implemented.” said David Juurlink, a clinical pharmacologist at the Sunnybrook Health Sciences Centre in Toronto and a member of Physicians for Responsible Opioid Prescribing, a nonprofit group based in New York that advocates for stricter prescribing.
We should note that still other organizations with ties to the pharmaceutical industry also objected to the guidelines. Prominently among them has been the American Cancer Society, which argued that the CDC used a flawed process to assemble the guidelines. In fact, the Washington Legal Foundation, a nonprofit aligned with the pharmaceutical industry, suggested the CDC might have violated federal law.
Consequently, the CDC postponed issuing its guidelines. Instead of releasing the proposal in December, the agency postponed that release date until yet another federal panel could review the suggestions. Last week, the National Center for Injury Prevention and Control’s Board of Scientific Counselors unanimously supported the guidelines. A CDC spokeswoman said there is no release data currently.
Four years ago, by the way, the US Senate Finance Committee, where Wyden is now the ranking member, opened an investigation into relationships between drug makers, physicians, and medical groups. The results have not been released. We asked a Wyden spokesman when documents will be made public and were told these cannot be released at this time without the committee preparing a full report.
This story was updated to reflect a comment from the HHS and a clarification from a Wyden spokesman about an earlier statement regarding the release of documents.