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Conflict of Interest in Medical Research, Education, and Practice
and the launching of start-up companies), does not report information by scientific field.1
Most professional societies and disease-focused or patient advocacy groups do not make public the details of funding received from industry, but it appears that many groups depend on medical product companies for a significant share of their overall revenues and for specific activities (e.g., continuing medical education and the development of clinical practice guidelines). In connection with congressional inquiries about its relationships with pharmaceutical companies, the American Psychiatric Association (APA) reported that medical companies supplied about 28 percent of its annual income. An informal APA survey of other medical specialty societies indicated that this figure was about in the middle of the range of the income that companies provide these groups (from 2 to nearly 50 percent) (Stotland, 2008). An Associated Press story on pharmaceutical company spending to promote the awareness of fibromyalgia reported that companies contributed funds that amounted to 40 percent of the annual budget of the National Fibromyalgia Association (Perrone, 2009). Many groups list corporate donors but do not report how much of their income is derived from these donors. Groups that report sources of funding for activities such as clinical practice guideline development usually do not report the amount of company funding for an activity or what percentage of an activity’s cost was accounted for by company funds. These data would assist with assessments of the risk of undue influence.
In a 2006 report for its board of directors, the American Academy of Family Physicians (AAFP) analyzed its resources and activities and concluded that it was not financially possible to forgo industry funding for any of its activities without imposing unacceptable cuts in services to members or increases in member costs. For its fiscal year 2006–2007 budget, AAFP projected that less than 38 percent of its income ($31 million of a total budget of $80 million) would come from dues and sales of products and services to members. Approximately 42 percent ($34 million) would come from the pharmaceutical industry, of which about 60 percent would come from advertising in the academy’s journal and 13 percent would come from payments for exhibits at meetings (AAFP, 2006a). The report noted that the organization had sought to broaden its base of nondues funding beyond pharmaceutical companies by seeking grants from government and foundations for various activities and
On the basis of its 2006 survey, the Association of University Technology Managers reported 12,672 actively managed licenses from patents as well as the introduction of 697 new products and 553 start-up companies (AUTM, 2007). It did not report the extent to which the institutions had financial stakes in the new products and companies. The survey covered 190 institutions, including 161 universities and 28 teaching hospitals and research institutions.