Nearly one health care company board member in every 10 also serves as a top academic from a renowned medical and research institution in the United States, a new study finds. This adds up to a total of 279 health care company board members affiliated with 85 non-profit academic institutions. 

While the Sunshine Act reveals the fees and gifts doctors receive from pharmaceutical companies, Obamacare’s transparency clause does not expose a professor moonlighting as a board member, say the researchers. Yet, such dual obligations pose a major conflict of interest.

Follow the Money

Beginning Wednesday, Jane and Joe Citizen will be able to search a government-run website and see all the consulting fees, stock options, and trips to Key West that pharmaceutical companies give to primary care physicians, ob/gyns, dermatologists, and other doctors. Known as the “Sunshine Act,” this transparency clause in the Affordable Care Act allows the Centers for Medicare & Medicaid Services to publicly post the many payments and valuables given to physicians and teaching hospitals. Yet, the new act does not explicitly require a professor to report payments earned as a company director. And “conflicts of interest are not specific to pharmaceutical companies, as competing interests may impact health care service and medical equipment industries as well,” wrote the authors.

So, what is the true extent of academia-industry conflicts?

For the study, Dr. Walid F. Gellad, associate professor, and his colleagues at University of Pittsburgh Medical Center, analyzed the prevalence and compensation of company directors who also held academic positions. The team focused on publicly-traded health care companies specializing in pharmaceuticals, biotechnology, medical equipment, or health care services. Searching company statements, the team found 442 companies disclosing information about their board of directors. Of these companies, 41 percent included at least one director with an academic affiliation, specifically 85 non-profit academic institutions, including 19 of the top 20 National Institutes of Health-funded medical schools.

Overall, 121 directors were professors and 85 were trustees, while 73 were chief executive officers, presidents, trustees, provosts, deans, and department chairs. 

The directors received, on average, annual payments of $193,000 in addition to significant stock options.

“How do we safeguard scientific and clinical integrity, ensuring that it is knowledge and not market share that shapes research and clinical practice? How do we keep the playing field level when industry dispenses hundreds of thousands of dollars to academic leaders?” Dr. David Rothman, a professor at Columbia College of Physicians and Surgeons, wrote in a linked editorial.

If anything, the study — which did not include large private companies, foreign companies, or start-ups — may have under-reported the full scope of ties between industry directors and academia. The authors concluded these conflicts "deserve additional review, regulation, and, in some cases, prohibition when [they] cannot be reconciled."

Source: Anderson TS, Good CB, Gellad WF.  Prevalence and compensation of academic leaders, professors, and trustees on publicly traded US healthcare company boards of directors: cross sectional study. BMJ. 2015.