In a page one article in the New York Times in the middle of September, it was reported that a leading physician in the field of breast cancer research had intentionally neglected to disclose the fact that he had been receiving millions of dollars from pharmaceutical companies.
In the dozens of articles that leading researcher Dr. Jose Baselga penned for such prestigious publications as The New England Journal of Medicine and The Lancet, he had omitted that he was accepting payments from various drug and health care companies.
As a highly visible and well-respected figure in the medical research community, Dr. Jose Baselga was the chief medical officer at Manhattan’s Memorial Sloan Kettering Cancer Center, until his untimely resignation just days after the NYT article appeared. Their research was possible with the help of ProPublica.
Dr. Baselga came to Memorial Sloan Kettering in 2013 after serving as chief of hematology and oncology at Massachusetts General Hospital in Boston. Before that he was a leader at the Vall d’Hebron Institute of Oncology in Barcelona, Spain.
Moreover, Dr. Baselga has served in an advisory capacity with such pharmaceutical companies at Roche and Bristol-Myers Squibb, among other drug companies. As such, his involvement with the companies has led to the development of breakthrough drugs that have revolutionized breast cancer treatment options. Dr. Baselga also resigned from the board of Bristol-Myers Squibb, which he had served on since March of 2018.
Since 2014, Dr. Baselga has received $3 million in consulting fees from Roche.
The egregious findings really rocked Memorial Sloan Kettering, (one of the nation’s leading cancer centers), to the core. The hospital’s leading executives made a feverish effort to tamp down the negative impact of such revelations on the institution’s reputation for medical excellence. They conducted urgent meetings of physician leaders and the executive committee of its board of directors.
In his resignation letter that he tendered in the days subsequent to the publication of the NYT article, Dr. Baselga said that he feared that the matter would be a distraction from his role overseeing clinical care and that he had been “extremely proud” to work at Memorial Sloan Kettering.
“It is my hope that this situation will inspire a doubling down on transparency in our field,” he said, adding that he hoped the medical community would work together to develop a more standardized system for reporting industry ties.
Sloan-Kettering insists it “has a rigorous and comprehensive compliance program in place to promote honesty and objectivity in scientific research.” Clearly that needs some work.
An analysis conducted by the New York Times and ProPublica resulted in the determination that Dr. Baselga was indeed negligent in complying with financial disclosure rules that are mandated by the American Association for Cancer Research when he was the president of the group.
As one of the two editors for “Cancer Discovery” – the AACR’s medical journal, the paper reported that Dr. Baselga also did not include in his articles any information about the payments that he had received from various companies that are linked to the field of cancer research.
The NYT reported that at a 2017 conference, Dr. Baselga had portrayed the results of two clinical drug trials sponsored by Roche quite favorably but had not disclosed that he had a working relationship with the company. Many of his medical contemporaries had viewed the results of the trials as disappointments.
For his part, Dr. Baselga did not deny that he had relationships with dozens of drug companies. In an interview with the New York Times, he had said that the omission of such payments was an oversight and not meant to be intentional.
About 10 years ago, information began emerging that the pharmaceutical industry was having a covert influence on drug research. This, in turn, aroused the ethics concerns of the medical community in terms of strengthening its conflict of interest requirements.
Respected figures in the medical community have posited that bias can occur if outside drug companies wield too much influence with researchers and doctors and can determine the manner in which clinical studies are designed and medications are prescribed to patients.
According to the NYT article, the AACR has instituted consequences for doctors who violate the disclosure rules. Although some consider the penalty not severe, the organization has told its journal authors that they would face a 3-year ban on publishing articles if they are found to have non-disclosed financial arrangements with drug companies.
Since 2013, Dr. Baselga has held board memberships with at least six drug companies according to the NYT report. In his role as a board member, the doctor has been required to protect the financial interests of the companies that he had worked with, while simultaneously overseeing the operations of the cancer center.
This has led to speculation that the two arrangements cannot coincide from an ethical standpoint and would be injurious not only to patients but to the reputations of doctors and the public trust in drug companies.
It has been reported that the mandating of physicians and researchers to disclose financial payments was first raised in 2010, when both Democrats and Republicans initiated the Physician Payments Sunshine Act and it became part of the Obama administration’s Affordable Care Act. It took a few years but in 2013, all health care programs were required to report financial partnerships with drug companies. Since that time, what has been made visible to the public on the internet is that over $8.4 billion in payments have been made to health care practitioners and institutions from the pharmaceutical industry.
Scientific and medical researchers, while trying to remain true to the highest ethical standards that their fields call for have at times begrudgingly admitted that such monetary infusion from the drug companies are absolutely essential for them and others to continue their research into cures for various forms of cancer and other fatal illnesses.
But let’s get back to Dr. Baselga for a moment. The fact that he did not disclose the $3,5 million that he took even when all of his co-authors made their financial records public is something that the mind cannot wrap itself around as it is borders on the bizarre. It has been reported that Baselga also has a financial interest in several start-up companies. Perhaps Dr. Baselga is a dedicated cancer researcher who has shown great care for his patients and the future of the medical research industry.
This, however, does not release Memorial Sloan Kettering Hospital from the responsibility of offering a cogent explanation of why one particular physician had any influence in deciding which pharmaceutical companies could conduct drug trials and which could not. This revelation puts Sloan Kettering’s research agenda in the forefront for further examination. Perhaps that is precisely where it should be.
Moreover, Sloan Kettering has the ultimate responsibility of ensuring that its patients are informed in no uncertain terms that no other doctors on its staff are taking money from drug companies to regain their trust.
By: Jerry Leebocker
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