Wednesday, May 20, 2015

Hep C irony renews questions of public confidence

In a nice touch of media irony, on the very day that Gilead Sciences, Inc. purchased a full page ad in the New York Times (web version here) talking about "new resources" available to fight Hepatitis C, a story by Andrew Pollack started with this lede:

Activists in several countries are seeking to void patents on the blockbuster hepatitis C drug Sovaldi, saying that the price being sought by the manufacturer, Gilead Sciences, was prohibitive.

The Initiative for Medicines, Access and Knowledge, a legal group in New York, is expected to announce Wednesday that it has filed challenges in Argentina, Brazil, China, Russia and Ukraine. In all those countries except China, the organization is being joined by local patient advocacy groups.

The actions are a sign that the controversy over Sovaldi is spreading beyond the United States, where the $84,000 charge for a course of treatment has strained Medicaid budgets, to middle-income countries.

My purpose today is not to offer an analysis of the pro's and con's of this issue. There's plenty of that discussion elsewhere.

My purpose instead is to again bring up the slippery slope that exists between academia and pharma.  As I discussed a year ago, when this controversy first arose, one of the board members of Gilead is Richard Whitley, a distinguished infectious disease doctor and researcher at the University of Alabama at Birmingham, who receives over $400,000 per year as compensation in his board role.  As I said then:

We can only imagine the extent of Dr. Whitley's personal commitment to eradicating disease.  This is truly an outstanding record.  I'd bet, too, that he would strongly support expanded access to Sovaldi for humanitarian reasons.  But in all the searches I have done, I can find no public statements from him concerning the financial issue raised in Andrew Pollack's [earlier] story.  Indeed, it would be very difficult for someone on the Gilead board to make a statement about such matters, as it would be viewed as inconsistent with the duty of loyalty and care required of corporate directors.

An extremely respected scientist with Dr. Whitley's credentials could be among the most qualified in society to "referee" this kind of issue--to help us understand and balance the legitimate financial needs of the pharmaceutical industry with the equally important humanitarian concerns about a drug's availability and cost in America.  He cannot do so while on the board of the company producing the drug. The loss to society is that someone of Dr. Whitley's expertise and compassion is taken out of the public debate on these matters.

Beyond that, what does his silence on this issue say to the country about his duty to two masters, a federally subsidized drug research effort and a pharmaceutical company? What message does that send to the public about how they should view the relationships between academic medical centers and industry? I think it doesn't help either sector retain the public's confidence.

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