Paul Rubin Should Stick to Economics

I’m not sure what drives economist Paul Rubin to write the editorial that appeared in the Atlanta Journal-Constitution on Tuesday. He appears to make the argument that unless pharmaceutical companies are allowed to consult with academicians, research (and therefore, ultimately new treatments and patients who might benefit from them) will suffer.

But nobody’s ever suggested banning such communication.

In a bizarre twist of logic that only someone suffering from psychosis might be able to appreciate, he apparently believes that Senator’s Grassley’s investigations are about stifling communication and innovation. Grassley has never said or claimed that researchers and pharmaceutical companies shouldn’t talk. All he has said is that if they talk — and the researchers get paid for that little “talk” — the researcher is ethical and reports such payments. What Grassley has uncovered is the criminal, unethical behavior of a half dozen or more psychiatric researchers (you know, people whom the rest of the field actually looks up to as the “gold” standard in psychiatric research) who take payments from pharmaceutical companies and then do not report them.

Rubin makes the patently absurd claim that since one such alleged criminal, Dr. Charles Nemeroff (a colleague of Rubin’s employed by the same university), consulted for 21 different clients, how could have a conflict of interest?

Umm, gee, I don’t know… Perhaps by designing research for all 21 clients to help ensure that each and every one of their products shows efficacy? I mean, if a guy has no druthers about not reporting over $1 million in income from these clients, I’m sure he could care less if he’s working for competing products as well.

But Rubin shows he doesn’t even understand the conflict of interest issue in the first place. He starts off his treatise with the following:

I also teach at Emory, but I do not know and have never communicated with Nemeroff, and no one at Emory has been contacted about this article. I have consulted for Pfizer but since as an economist I cannot write prescriptions and I have not been paid for this article, no one can accuse me of conflicts of interest.

So Rubin believes he has no conflict of interest in writing this article (and the AJC has none in publishing the article) despite the fact that Rubin:

• Is employed by the same university as one of the professionals he’s writing about being “unfairly” targeted by Grassley
• Has consulted for the one of the same companies that has given money to the professionals who have been targeted by Grassley
• Would directly benefit through positive press for either Emory (and its employees, such as Nemeroff) or Pfizer, in increased prestige or consulting gigs

Sorry, Paul. That is the very definition of conflict of interest! Conflict of interest doesn’t exist in some sort of hypothetical vacuum where if you get paid by Company X, you’re beholden to Company X for all of time. A conflict of interest generally

refers to situations in which financial or other personal considerations may adversely affect, or have the appearance of adversely affecting, an employee’s professional judgment in exercising any University duty or responsibility in administration, management, instruction, research and other professional activities. [quoted from one University’s policy]

You see, you don’t just need to be making a bucket of money from a company, but it could be for the prestige (for instance, being the leading industry consultant on a particular topic). And it could not be for actual gain, but just have the appearance of adversely affecting the researcher’s (or economist’s) results.

Rubin writes,

If Grassley is successful in his policies, then physicians like Nemeroff will simply cease doing research for NIH. The result will be fewer new drugs available for patients, and less information for physicians and patients about the drugs that are developed.

Why? The logic doesn’t follow. Why wouldn’t researchers like Nemeroff simply report their income accurately from drug companies? And trust me, for every Nemeroff that shines in the spotlight, there are a dozen new researchers waiting to take the drug companies’ funding. There will never be a paucity of researchers willing to work to for a pharmaceutical company. And of course, there’s nothing stopping drug companies fully funding (as they so often do) such research themselves. Apparently Rubin knows so little about psychiatric research, he doesn’t even realize this (or if he does, he cynically leaves it out of his article).

Grassley’s investigations have absolutely nothing to do with stifling innovation or researchers’ ability to communicate and interact directly with pharmaceutical companies. They have everything to do with researchers acting in an ethical manner and reporting the income they make (and as already required by their universities).

And as for the absurd suggestion that such government oversight (oversight, frankly, that should be done on a regular basis via a regulatory agency) will result in “patient suffering,” well, I’ll turn it back onto Rubin. Show me the research that shows as much, and I’ll believe you. Otherwise, I’d suggest you take your trick-or-treating scare tactics to the next house on your Halloween route.

Read the editorial: If politician’s war on drugs continue, patients will suffer

Read Furious Seasons’ take on it: Economist Says It’s OK For Psychiatric Researchers To Be Corrupt