Should Doctors Reveal Financial Conflicts When Speaking in the Media?

2019-07-18

C&BP Asked Medical Board of California President Denise Pines About Stanford’s Brock-Utne MD

Financial reporting standards in medicine are moving toward greater transparency. A recent, independent survey showed that while half of the reviewed conflict of interest policies had a threshold of $0 for reporting payments to doctors by industry, the rest were set between $200 and $10,000.

Stanford University appears to be ignoring this trend. For the past five months, Stanford has avoided questions we’ve asked about payments of nearly $50,000 received by Professor of Anesthesia John G. Brock-Utne, MD, over five years from drug makers and medical device suppliers.

So, we sent an inquiry to the organization that licenses physicians in the Golden State — the Medical Board of California.

In a recent letter to the Board’s President Denise Pines, we asked if the Medical Board of California (MBC) has ethical standards for doctors who have received payments from drug and medical device companies and advocate for positions in the media that may benefit those companies. And if not, why not?

Since October 2018, we’ve been looking into a group called Physicians Against Drug Shortages (PADS) and its media campaign against group purchasing organizations that negotiate bulk purchase prices of drugs and medical supplies for hospitals.

Dr. Brock-Utne is a co-chair of this organization. Last December, Anesthesiology News, Clinical Oncology News and The Bulletin ran an article he authored in which he argues that “companies that don’t get contracts” with group purchasing organizations (GPO) “can’t compete and are forced to halt production.”

Dr. Brock-Utne has a right to free speech. But his patients, the medical community and the public have a right to know about the industry payments he received and did not reveal in his article.

Our Investigation has Uncovered Three, Separate Potential Conflicts

The first, and most recent, is Dr. John Brock-Utne’s board membership at his son’s medical software company, Issio Solutions, Inc. Issio offers health IT and consulting services, including a cloud-based staff communications and scheduling tool for surgical centers. According to an informed source, the company received $5.5 million in three tranches of venture capital funding from 2012 to 2015. In the 2012 funding tranche, 1,110,000 shares were authorized at a conversion price of $1, according to PitchBook. An additional unknown number of shares were authorized in 2014 and 2015. The company’s valuation in 2015 was estimated to be $11.5 million.

For-profit company directors often receive compensation in cash, company stock, stock options, or a combination. This begs the question: Did Dr. Brock-Utne get compensated for serving on Issio’s board and does he still hold an equity stake in the company? If so, why did he not reveal that in his article?

The second area of concern was discovered using the CMS Open Payments database. It shows that in the three-year period from 2014-16, Dr. Brock-Utne received 57 payments from drug and medical device companies. Each year totaled more than $10,000.

The largest payments were $23,739.30 from Grifols USA, a plasma-derived biological medicines producer; next was $14,673.64 from Mylan Specialty, a producer of EpiPen and EpiPen Jr auto-injectors, as well as other prescription drug products. The payments were defined as “not associated with a research study.” Why was the doctor not transparent about these payments in his article?

The third area of potential financial conflict concerns privately held Spectros Corporation, a molecular sensing and diagnostic tools company, where Dr. Brock-Utne served on the board of directors. If there was financial compensation for his service, why was that not revealed that in his article?

Financial payments by certain drug and medical device companies have gone unmentioned by PADS co-chairs in a series of opinion pieces and media appearances. Additionally, PADS and its co-chairs appear to ignore any responsibility borne by drug and medical device manufacturers for high prices.

Brock-Utne has been silent about fees received from drug and medical device companies in his public commentary. We have attempted to contact him by email and registered letter, which was refused. To date, we have received no response from the doctor about our inquiries.

Undeclared Medical Industry Payments A Growing Concern

Doctors who do not declare medical industry payments are a growing concern to consumers, medical journals and associations.

This new JAMA Internal Medicine study examines how widespread the problem of unreported payments to laboratory medical directors is. Last year, Dr. José Baselga was forced to resign from Memorial Sloan Kettering Cancer Center as one of the editors in chief of Cancer Discovery. He also had to step down from the boards of three drug and equipment makers after he failed to accurately declare payments he received from health care companies.

A U.S. Preventive Services task force last year reviewed conflicts of interest (COI) policies of ten organizations and interviewed staff who had developed and implemented them at federal agencies and similar groups. In a special report published in the American Journal of Preventative Medicine, the task force wrote,

“More than half of the reviewed policies had a threshold of $0 whereas the rest were set between $200 and $10,000.”

Then, there’s the National Academy of Medicine that has a $10,000 minimum threshold for declaring financial interests. Dr. Brock-Utne has not been transparent about payments he has received from drug and medical device companies that well exceed these recommended thresholds.

Perhaps there’s an explanation for the lack of transparency and all three of Dr. Brock-Utne’s potential conflicts. The doctor and Stanford University seem to hope the questions will just go away. Perhaps the Medical Board of California has an answer.

Scott Peterson is executive director of Checks and Balances Project, an investigative watchdog blog that seeks to hold government officials, lobbyists and corporate management accountable to the public. Funding for C&BP is provided by Renew American Prosperity and individual donors.