UC College of Medicine Strengthens Conflict of Interest Policies

CINCINNATI—In an age of increased university-industry interactions, universities—particularly medical colleges—are taking steps to avoid creating conflicts of interest that could compromise their research, education and clinical missions.

The University of Cincinnati (UC) College of Medicine recently convened a group of faculty and administrators to review university policies for industry interactions and to develop new policies as necessary.

The recently approved “Policy and Guidelines for Industry Relationships”—which becomes effective May 15, 2008—relates to research and scholarly activity, clinical training, patient care, consulting, collateral employment and technology transfer.

“As a medical college, our role is to achieve excellence in research, teaching and patient care by employing the highest ethical standards,” says David Stern, MD, College of Medicine dean and vice president for health affairs at UC’s Academic Health Center. “Improved guidelines for university-industry interactions will help our faculty to navigate these very important relationships while also maintaining the integrity of their work.”

The most significant changes to the College’s policy are rules dealing with the regulation of pharmaceutical and device company influences on teaching and patient care activities.

The new policy prohibits UC personnel from accepting from industry representatives any gift or other form of compensation unless the payment is for legitimate services. Gifts include, but are not limited to, food, beverages, pharmaceutical or device samples or travel-related expenses. Not included in the list of prohibited gifts are pharmaceutical samples provided for indigent care.

The new policy also prohibits industry representatives—other than service personnel—from being on campus unless they are here for specific appointments with faculty or authorized staff members.

“There is a concern that the pharmaceutical industry has an undue influence on prescribing patterns of practicing physicians and that they cultivate this relationship early on—as early as medical school,” says Andrew Filak, MD, senior associate dean for academic affairs at the UC College of Medicine.

Laura Wexler, MD, professor of medicine and associate dean for student affairs and admissions, says there’s substantial research suggesting gifts, lunches, travel support and other types of industry ‘give-aways’ actually do influence physicians—even when physicians don’t think they are being influenced.

“We also need to be concerned about the perception of conflict of interest,” Wexler says. “For example, how does the public, who we serve as physicians and educators, view the activities of the pharmaceutical industry at a college of medicine?”

Filak says there is a growing body of literature on the marketing tactics and influence of industry, and that a number of physicians and students are taking a stance against the common practices employed by some pharmaceutical companies, including the provision of gifts and lunches.

In contrast to industry gifts, Wexler and Filak acknowledge that industry support of medical research is a more complicated topic. Many investigators feel very strongly that industry research support—which UC increased by 40 percent in 2007—is essential to innovative medical discoveries and is a major driver for drug and device development. UC’s new policy reiterates and clarifies the College’s guidelines for the conduct and reporting of industry-sponsored research.

Filak and Wexler both agree the policies created by the College of Medicine are in line with what other colleges are doing nationwide.