Advisers on Vaccines Often Have Conflicts, Report Says

http://www.nytimes.com/2009/12/18/he...r=3&ref=health

Advisers on Vaccines Often Have Conflicts, Report Says
By GARDINER HARRIS
Published: December 17, 2009

WASHINGTON * A new report finds that the Centers for Disease Control and
Prevention did a poor job of screening medical experts for financial
conflicts when it hired them to advise the agency on vaccine safety,
officials said Thursday.


Most of the experts who served on advisory panels in 2007 to evaluate
vaccines for flu and cervical cancer had potential conflicts that were never
resolved, the report said. Some were legally barred from considering the
issues but did so anyway.

In the report, expected to be released Friday, Daniel R. Levinson, the
inspector general of the Department of Health and Human Services, found that
the centers failed nearly every time to ensure that the experts adequately
filled out forms confirming they were not being paid by companies with an
interest in their decisions.

The report found that 64 percent of the advisers had potential conflicts of
interest that were never identified or were left unresolved by the centers.
Thirteen percent failed to have an appropriate conflicts form on file at the
agency at all, which should have barred their participation in the meetings
entirely, Mr. Levinson found. And 3 percent voted on matters that ethics
officers had already barred them from considering.

The inspector general recommended that the centers do a far better job of
screening. In a reply, the agency's new director, Dr. Thomas R. Frieden,
agreed.

"Since the period covered in this review, C.D.C. has strengthened the
financial disclosures and conflict-of-interest process by instituting
improved business processes and realigning responsibilities and oversight,"
Dr. Frieden wrote.

As numerous medicines have been pulled from the market in recent years,
worries have grown that experts may be recommending medical products * even
ones they know to be unsafe * in part because manufacturers are paying them.

As a result, government agencies, medical societies and medical journals
have become increasingly insistent that experts disclose potential
conflicts. And while the experts invariably insist that they have done so,
government audits routinely find large gaps between these disclosures and
the experts' actual income from consulting.

Congress tightened the rules on outside consulting after similar conflicts
were found among members of advisory panels to the Food and Drug
Administration. But little attention has been paid to the potential
conflicts of advisers to the C.D.C., even though that agency's committees
have significant influence over what vaccines are sold in the United States,
what tests are performed to detect cancer and how coal miners are protected.

Most of the advisers identified by Mr. Levinson had either a job or a grant
from a company or other entity whose interests were affected by the
committees' discussions, and a considerable number also owned stock in such
companies, the report said.

Representative Rosa DeLauro, a Connecticut Democrat who said she had long
been a supporter of the C.D.C., said: "That is why I am so concerned about
this report issued by the inspector general exposing serious ethics
violations within the C.D.C. All members of the federal advisory committees,
whose recommendations direct federal policy, should be without conflict of
interest."