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DR PAUL RICHARDSON:
WILL YOU WEAR A PHARMA-POWER-DISCLOSURE BADGE?

by Semmel Weis
First published 21Dec2017  Last edited 10Feb2018  05:16am



 
The following was sent on 30Dec2017 12:09pm to Dr Paul Richardson at the email address published on the DANA-FARBER CANCER INSTITUTE web site:  paul_richardson@dfci.harvard.edu

Email sent to Paul Richardson

And got back:


In the Darzalex (Daratumumab) -promoting infomercial, POLLUX, of which you are a co-author, a footnote discloses no more than that "Dr. Richardson, receiving fees for serving on advisory boards from Celgene and Janssen", which must strike anyone as not only unhelpful, but evasive, as the information that would be helpful is not whether an author received some payments from medical-treatment corporations, no matter how small, but whether the author received ten dollars or ten thousand dollars or ten million dollars.

Moving on to searching for such missing detail within the 78-page Potential Conflicts of Interest of the authors of POLLUX, the section devoted to you (once on that web page, search for "Richardson", without the quotation marks) is no more informative, containing nothing more specific than the following:

Failure of Dr Paul Richardson to make full disclosure of conflict of interest payments received
Failure of Dr Paul Richardson to make full disclosure of conflict of interest payments received
Failure of Dr Paul Richardson to make full disclosure of conflict of interest payments received

However, information that during 2013-2016 you were paid $19.6 million by medical-treatment corporations is available from CMS, a figure that I call your Pharma Power, and which could — and should — have been included in both of the locations consulted above — that is, in the footnote at the bottom of the POLLUX article, and in the separate Potential Conflicts of Interest report.

If a badge or card showing Pharma Power were worn as shown below (much smaller would be fine), conflict of interest disclosure would be delivered not a crumb at a time to the infinitesimally-few people who read footnotes in medical-journal articles, but by the bushel to patients receiving therapy, and subjects receiving experimental treatment, and audiences listening to speakers or watching interviews.

Not the least among the advantages to the patient of seeing Pharma-Power badges is the badges being able to awaken the realization that what at first appeared to be health-care professionals expressing a consensus as to the treatment which optimizes patient welfare, upon later reflection looked more like salesmen who had agreed on a spiel which maximizes profits.

A reminder that a Pharma Power badge can be read thusly: "Big Pharma's power over me has the strength of 19.6 million dollars".

A DANA-FARBER MULTIPLE-MYELOMA TRIO
shown transported to an imaginary world in which
doctors disclose their own Pharma-Power dependence
blog.dana-farber.org
A DANA-FARBER MULTIPLE-MYELOMA TRIO: Anderson, Richardson, Munshi

PHARMA-POWER VALUES ARE THE SUMS OF THE SMALL-FONT PAYMENTS IMMEDIATELY ABOVE THEM:

Dr KENNETH C ANDERSON of the Dana-Farber Cancer Institute
Dr KENNETH C ANDERSON
Dana-Farber Cancer Institute, Boston MA
Dr PAUL G RICHARDSON of the Dana-Farber Cancer Institute
Dr PAUL RICHARDSON
Dana-Farber Cancer Institute, Boston MA
Dr PAUL G RICHARDSON of the Dana-Farber Cancer Institute
Dr NIKHIL MUNSHI
Dana-Farber Cancer Institute, Boston MA
2016
General Payments   $1,961,332
Research Payments        $5,221
Associated Research           N/A
2016
General Payments           $86,361
Research Payments         $16,383
Associated Research   $4,718,058
2016
General Payments           $22,310
Research Payments           $1,564
Associated Research        $84,500
2015
General Payments        $67,174
Research Payments        $1,443
Associated Research     $50,000
2015
General Payments           $59,331
Research Payments         $16,478
Associated Research   $4,434,189
2015
General Payments           $34,739
Research Payments              N/A
Associated Research          $4,135
2014
General Payments         $89,102
Research Payments         $6,070
Associated Research    $127,248
2014
General Payments          $98,483
Research Payments          $7,057
Associated Research   $6,612,461
2014
General Payments          $27,584
Research Payments              N/A
Associated Research         $1,658
2013 (Aug-Dec)
General Payments         $84,810
Research Payments         $4,700
Associated Research             N/A
2013 (Aug-Dec)
General Payments           $13,235
Research Payments           $7,538
Associated Research   $3,578,222
2013 (Aug-Dec)
General Payments           $4,132
Research Payments              N/A
Associated Research      $30,723
Pharma Power badge belonging to Dr KENNETH C ANDERSON over Dr Ken Anderson has the strength of
$2,397,100
openpaymentsdata.cms
Pharma Power badge belonging to Dr PAUL G RICHARDSON over Dr Paul Richardson has the strength of
$19,647,796
openpaymentsdata.cms
Pharma Power badge belonging to Dr NIKHIL MUNSHI over Dr Nikhil Munshi has the strength of
$211,345
openpaymentsdata.cms

  Doctor's lab coat sporting Big Pharma logos

How tragic that even if a measure as revolutionary as doctors wearing Pharma-Power badges were adopted, the plight of cancer patients might be little improved, because their opting to be treated by doctors who don't take Big Pharma payments might leave them nevertheless in the hands of doctors with qualms about jeopardizing the income of fellow doctors who do take Big Pharma payments, or in the hands of doctors with qualms about jeopardizing the income of the institutions with which they are affiliated.

And anyway, even the improved disclosure of a single Pharma-Power number attached to every doctor would still be only a small step toward figuring out exactly which Big Pharmas were paying exactly which doctors exactly how much to supply exactly what services to strengthen corporate health at exactly what sacrifice of patient health.  To begin to unravel that whole story would require information that is more specific than the OpenPaymentsData.CMS data examined so far, specifically data that would attach a Pharma-Power number to every logo in the illustration opposite.  Such more specific data is available on OpenPaymentsData.CMS, and will be examined as time and resources permit.

Dr Alfred E Neuman, standing for unquestioning stupidity, is pictured as simultaneously blind to the impropriety of sponsoring pharmaceuticals source

 

In conclusion, I urge you to hasten your reply to the charge that Kaplan-Meier graphs are misleading, which charge I first posted online six months ago, and which I brought to your personal attention two weeks ago.  The longer you leave this charge unanswered, the more likely you are to arouse in some minds the suspicion that over the course of your career you have failed to notice a rather obvious defect in a statistical tool that you often rely on, and that when the defect is brought to your attention, you are unable to deny it, and even that you feel yourself under no obligation to address it.

And I urge you also to take immediate action concerning the conflict of interest whose magnitude you have failed to disclose everywhere it has been obligatory to disclose it, "everywhere" including every article of which you have been lead-author or co-author, and every speech you made, and every interview you gave, and every opinion you delivered to a patient.

Were you to fail to take both these steps, you would be in danger of projecting an image not unlike that of Dr Alfred E Neuman opposite — that is, the image of someone unfit for his work and untroubled by considerations of conflict-of-interest.


Has the day arrived when every
Alfred E Neuman of politics
begins to be matched by an
Alfred E Neuman of medicine?

George W Bush Vladimir Putin Donald Trump
"Over the decades, Neuman has frequently been referenced in outside media, and his face has often appeared in political cartoons as a shorthand for unquestioning stupidity."    Wikipedia


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