The Crikey Register of Influence
Below we identify some of the associations between key opinion leaders and industry marketing or disease-awareness campaigns.It is published in the interests of fostering greater transparency and a more open debate about these links.
It is not intended to denigrate the key opinion leaders themselves — their involvement in such campaigns is a reflection of their expertise and standing, and reflects genuine professional concerns.
Those named on their list are welcome to contribute their comments by emailing [email protected].
To suggest additions to the Crikey Register of Influence, please contact ([email protected]). We require documentary evidence of an association, such as a copy of a press release, advertorial or other promotional material.
Key opinion leaders: Health and medicine
- Associate Professor John Amerena, cardiologist, Geelong Hospital, quoted in an advertorial for a new hypertension treatment, Micardis Plus 80/25 mg, sponsored by Boehringer Ingelheim, Australian Doctor (6.3.2009; 13.3.2009)
- NEW Associate Professor John Amerena, cardiologist, University of Melbourne (Geelong), Professor Greg Fulcher, Royal North Shore Hospital, Sydney, and Associate Professor Christopher Levi, John Hunter Hospital, Newcastle, appear in an advertorial promoting Micardis (telmisartan) for prevention of cardiovascular complications in high-risk diabetes patients (Australian Doctor, 9 April, 2010), funded by Boehringer Ingelheim.
- Dr James Best, Inner West General Practice, Leichhardt, quoted in an advertorial on depression treatment, sponsored by Boehringer Ingelheim and Eli Lilly that ran in Australian Doctor (23.10.2009; 20.11.2009)
- Adjunct Associate Professor, Renee Bittoun, University of Sydney. Author of a report funded by “an unrestricted educational grant” from GlaxoSmithKline Consumer Healthcare Australia Pty Ltd. “A decade of over-the- counter therapeutic nicotine in Australia Its contribution to improving quit rates and saving lives”, published May 2007. It stated “GSK had no editorial input in the preparation of this report”.
- NEW Professor Maureen Black, Professor of Pediatrics, University of Maryland School of Medicine and director of the Growth and Nutrition Clinic, appears in an advertorial on children’s nutrition (Australian Doctor, 26 Nov 2010), sponsored by Nutricia, which is part of Danone Baby Nutrition Asia Pacific and makes infant formulas and supplements.
- NEW Professor Jennie Brand-Miller, Professor of Human Nutrition, University of Sydney, appears in an advertorial on infant nutrition (Australian Doctor, 19 Nov 2010), sponsored by Nutricia, which is part of Danone Baby Nutrition Asia Pacific and makes infant formulas and supplements.
- Dr Jack Burks, a neurologist and Clinical Professor of Medicine at the University of Nevada School of Medicine (Reno, Nevada), Vice President and chief medical officer of the Multiple Sclerosis Association of America. He has featured in DVDs and brochures distributed at MS conferences in Australia which have featured a Schering product, Betaferon. His website states that he has been a consultant or speaker for the following companies: Bayer, Schering, Serono, Teva, Pfizer, Bios MS Medical, Cephalon, Schwarz, Wellpoint, MedImpact, Intramed, Cogenix, Medacor, Medicom.
- NEW Dr James O’Callaghan, pain medicine specialist, Axxon Health, appears in Medtronic advertorial promoting neurostimulation for chronic pain (Australian Doctor, 3 December, 2010)
- Dr Melinda Carrington, General Manager, Disease Management and Preventative Programs, Baker IDI Heart and Diabetes Institute. Appeared in an advertorial promoting cholesterol treatment commissioned by AstraZeneca. (Medical Observer, July 2009). The close links between the Baker and other industry marketing campaigns have been the subject of previous controversy (more info here).
- Professor Derek P Chew, Professor of Cardiology, Flinders University. Appears in a Sanofi Aventis advertorial, promoting treatment of heart attacks and unstable angina, Australian Doctor (27.6.08)
- Professor Peter Clifton, CSIRO, visiting physician Royal Adelaide Hospital and Flinders Medical Centre. Appears in an advertorial for a spread that is claimed to be beneficial for cholesterol, Logicol, Australian Doctor (27.6.08, 20.2.2009)
- NEW Dr B Eliot Cole, executive director, American Society of Pain Educators, appears in at least six advertorials promoting Cymbalta (duloxetine) for diabetic peripheral neuropathic pain (Australian Doctor & Medical Observer, 2010). The advertorial, funded by Boehringer Ingelheim and Eli Lilly, says he visited Australia to present data on Cymbalta.
- Associate Professor David Colquhoun, cardiologist at Brisbane’s Greenslopes Hospital and Professor of Medicine at the University of Queensland, quoted in a press release promoting foods or supplements with omega-3s in improving cardiovascular outcomes. The release was issued on 3 December, 2007, by the Omega-3 Centre, which aims to promote omega-3s in Australia and NZ. The Centre’s members are Nu-Mega Ingredients, Ocean Nutrition Canada, DSM Nutritional Products Australia, BASF Human Nutrition, Nutricia Australia, Simplot Australia Pty Ltd, King Salmon NZ, Fisheries Research and Development Corp, George Weston Foods, CSIRO Food Futures & Preventative Health Flagships, Croda Australia, Meat & Livestock Australia, Martek Biosciences Corporations, Global Organisation for EPA and DHA (GOED), and Omega3 Learning Consortium.
- NEW Dr Raymond Cook, neurosurgeon, and Dr Paul Silberstein, neurologist, of the Sydney Parkinson’s and Movement Disorder Surgery Unit and two of the authors of the Australian Deep Brain Stimulation guidelines, appear in a Medtronic advertorial promoting deep brain stimulation for Parkinson’s disease (2 July, 2010, Australian Doctor)
- Dr Fred de Looze, GP, Queensland, quoted in an advertorial on blood pressure management sponsored by Bristol-Myers Squibb Pharmaceuticals, Australian Doctor (7.8.2009)
- Professor Geoffrey Donnan, Director of the National Stroke Research Institute, Austin Hospital, Melbourne. Quoted in an advertorial about a study comparing treatments for recurrent stroke prevention. The advertorial is sponsored by Boehringer Ingelheim, which makes one of the treatments, dipyridamole, and ran in Australian Doctor (21.11.08; 28.11.08; 12.12.2008; 19.12.2008) and Medical Observer (28.11.08, 5.12.2008)
- Dr Brett Forge, physician and cardiologist, West Gippsland Hospital, Victoria, quoted in an AstraZeneca advertorial about cardiovascular disease. Medical Observer (19.9.08)
- NEW Professor Greg Fulcher, director of diabetes, endocrinology and metabolism, Royal North Shore Hospital, Sydney, appears in at least five advertorials promoting Micardis (telmisartan) for prevention of cardiovascular complications in high-risk diabetes patients (Australian Doctor 2010, Medical Observer 2010), funded by Boehringer Ingelheim.
- NEW Professor Johan Garssen, director of immunology platform at Danone Research Centre for Specialised Nutrition, The Netherlands and Research Program Leader, immunopharmacology at Utrecht Institute for Pharmaceutical Sciences. He appears in an advertorial on children’s nutrition (Australian Doctor, 5 Nov 2010), sponsored by Nutricia, which is part of Danone Baby Nutrition Asia Pacific and makes infant formulas and supplements.
- Kurt Gebauer, Clinical Associate Professor of Dermatology, University of WA. Appears in an advertorial for Aldara (imiquimod), a treatment for solar keratoses, sponsored by Inova Pharmaceuticals. Australian Doctor (18.7.08)
- Dr Murray Gerstman, endocrinologist, quoted in an advertorial on insulin therapy and diabetes, sponsored by Novo Nordisk, that ran in Medical Observer (13.11.2009; 20.11.2009)
- Dr Jenny Gowan, consultant pharmacist, quoted in an advertorial for Nurofen, sponsored by Reckitt Benckiser, in Pharmacy News and in a resource for pharmacy assistants published by Pharmacy News in late 2009.
- NEW Dr Peter Hewett, head of colorectal unit, Queen Elizabeth Hospital, Adelaide, and Dr Ian Tucker, urogynaecologist and vice president of the Continence Foundation of Australia, appear in an advertorial promoting sacral nerve stimulation for incontinence (Australian Doctor, 6 August, 2010)
- Associate Professor Peter Holmes, respiratory physician, Monash Medical Centre, Melbourne, quoted in an advertorial promoting SPIRIVA (tiotropium) for chronic obstructive pulmonary disease, sponsored by Pfizer Australia and Boehringer Ingelheim, Australian Doctor and Medical Observer, early 2009.
- Clinical Associate Professor David Horgan, Departments of Psychiatry, University of Melbourne and Royal Melbourne Hospital, quoted in an advertorial on depression treatment, sponsored by Boehringer Ingelheim and Eli Lilly that ran in Australian Doctor (23.10.2009; 20.11.2009)
- Dr Roman Jaworski, consultant rheumatologist, a consultant at Wollongong Hospital and a clinical Associate Professor at the Graduate School of Medicine, University of Wollongong, appears in an Australian Doctor advertorial promoting Panadol Osteo for osteoarthritis pain. It is sponsored by GlaxoSmithKline (17.10.08).
- Dr Gary Kilove, Melbourne GP, quoted in an advertorial promoting SPIRIVA (tiotropium) for chronic obstructive pulmonary disease, sponsored by Pfizer Australia and Boehringer Ingelheim, Australian Doctor and Medical Observer, early 2009.
- Dr Rosie King, of the Australian Centre for Sexual Health, St Luke’s Hospital, Sydney, is credited for contributing to content on a website that encourages men to seek help for erection problems. The website is produced by Viagra’s manufacturer, Pfizer Australia, and Dr King’s role is mentioned here.
- NEW Professor Sibylle Koletzko, Head of the Division of Paediatric Gastroenterology and Hepatology at the Dr.v.Haunersches Kinderspital, Munich, Germany, appears in an advertorial on infant nutrition (Australian Doctor, Nov, 2010), sponsored by Nutricia, which is part of Danone Baby Nutrition Asia Pacific and makes infant formulas and supplements.
- NEW Associate Professor Karam Kostner, lipidologist and cardiologist, associate professor of medicine, University of Queensland, Mater Hospital, Brisbane, quoted in advertorials “The facts about eggs and nutrition” and “The nutritional benefits of eggs throughout life’s journey” and “The latest nutrition news on Australian eggs”,(Medical Observer, 28 May, 25 June, 30 July, 2010, Australian Doctor, 25 June and other issues 2010), sponsored by Egg Nutrition Council.
- Professor Henry Krum, CCRE Therapeutics, Monash University, quoted in an advertorial on blood pressure management sponsored by Bristol-Myers Squibb Pharmaceuticals, Australian Doctor (7.8.2009)
- John Knowlton, past president of The Society of Cosmetic Chemists of Great Britain, quoted in an advertisement promoting a Union-Swiss skin care product, Bio-Oil. Medical Observer (11.7.08; 26.9.2008)
- Dr David Lim, GP, Newtown, Sydney, quoted in an AstraZeneca advertorial about cardiovascular disease. Medical Observer (19.9.08)
- Dr Stephen Li, Director of the Lipid and Cardiovascular Risk Assessment Service at Westmead Hospital and Chairman of Community Health for the Australian Chinese Medical Association, appears in an advertorial promoting AstraZeneca’s cholesterol lowering drug rosuvastatin or Crestor in treating Asian patients. Medical Observer (24.10.08)
- Associate Professor Doug Lording, endocrinologist and andrologist at Melbourne’s Cabrini Hospital. Appeared in a press release for Eli Lilly promoting a new drug for erectile dysfunction (Cialis), which was widely reported in the media, including by the SMH. The release was subsequently found in breach of the Medicines Australia Code of Conduct.
- NEW Dr Tania Markovic, consulting endocrinologist at Royal Prince Alfred Hospital, Sydney and a member of the Egg Nutrition Council, quoted in an advertorial “Busting the myths around eggs and serum cholesterol” (Medical Observer, 1 Oct, 5 Nov, 2010), sponsored by Egg Nutrition Council.
- Dr Tom Mayze, Psychiatrist, The Brisbane Clinic, quoted in an advertorial on depression treatment, sponsored by Boehringer Ingelheim and Eli Lilly that ran in Australian Doctor (23.10.2009; 20.11.2009)
- Dr Elizabeth McDonald, multiple sclerosis rehabilitation specialist and medical director of MS Australia, quoted in an advertorial for MS treatment system, sponsored by Bayer HealthCare and Bayer Schering Pharma, in Medical Observer (18.9.2009)
- Associate Professor Richard O’Brien, Endocrinologist and Clinical Dean, University of Melbourne. Quoted in an advertisement that suggests coffee may help lower type 2 diabetes risk, sponsored by Nescafe, Australian Doctor (27.6.08; 25.7.08; 22.8.08; 5.9.08)
- NEW Dr David O’Neal, endocrinologist, St Vincent’s hospital, Melbourne, quoted in a Medtronic Australasia advertorial (Australian Doctor, 15 October, 2010, 5 Nov 2010, & Medical Observer, 5 Nov, 2010) promoting insulin pump therapy for selected patients with Type 1 diabetes.
- Professor Michael O’Rourke, Head of the Vascular Ventricular Interactions Program at the Victor Chang Cardiac Research Unit, University of NSW, quoted in an advertorial on “devastating consequences of large-artery stiffening”, developed by Elixir Healthcare Education on behalf of Bristol-Myers ASquibb Pharmaceuticals. Australian Doctor (30.10.2009)
- Associate Professor Matthew Peters, Concord Repatriation Hospital, Sydney, quoted in an advertorial promoting SPIRIVA (tiotropium) for chronic obstructive pulmonary disease, sponsored by Pfizer Australia and Boehringer Ingelheim, Australian Doctor and Medical Observer, early 2009.
- NEW Associate Professor Thanh Phan, head of stroke, Monash Medical Centre, consultant neurologist for Southern Health; Clinical Associate Professor, Southern Clinical School, Monash University, appears in advertorials promoting Asasantin (dipyridamole plus aspirin) for secondary prevention of stroke and TIAs (Medical Observer, 13 August, 3 September and at least another two issues in 2010), funded by Boehringer Ingelheim.
- Dr George Proimos, cardiologist, Austin Hospital, Melbourne, quoted in an advertorial for a new hypertension treatment, Micardis Plus 80/25 mg, sponsored by Boehringer Ingelheim, Australian Doctor (6.3.2009; 13.3.2009)
- Associate Professor Chris Reid, CCRE Therapeutics, Monash University, in an advertorial on blood pressure management sponsored by Bristol-Myers Squibb Pharmaceuticals, Australian Doctor (7.8.2009)
- Professor Gregory Rice, a scientist from the Baker IDI Heart and Diabetes Institute in Melbourne, is Non Executive Chairman and a co-founder of HealthLinx and a co-inventor of key patents. He also has a contract to provide “science and operations services” to the company. Professor Rice was quoted in a media campaign in November 2008 promoting the company’s launch of a new diagnostic test for ovarian cancer, the OvPlex test.
- Dr Rick Sapsford, Albany Hills Radius Medical Centre, Qld, quoted in an advertorial on depression treatment, sponsored by Boehringer Ingelheim and Eli Lilly that ran in Australian Doctor (2009)
- NEW Dr Raymond Seidler, GP, Kings Cross, Sydney, is interviewed as part of a two-page advertorial on the treatment of bipolar disorder funded by AstraZeneca (which makes a bipolar treatment) (Australian Doctor, 26 Nov 2010). This advertorial ran in the leadup to announcements of an expanded PBS listing for the company’s drug, Seroquel.
- Professor Andrew Sinclair, Professor of Human Nutrition, Deakin University, quoted in a press release encouraging children to eat more fish and other foods rich in long chain omega-3s. The release was issued on 19 September, 2007, by the Omega-3 Centre, which aims to promote omega-3s in Australia and NZ. Professor Sinclair was also quoted in a press release issued by the Centre on 17 April 2007 promoting the links between children’s health and omega-3s. He was quoted as “Scientific Advisor to the Omega-3 Centre”. The Omega-3 Centre’s members are Nu-Mega Ingredients, Ocean Nutrition Canada, DSM Nutritional Products Australia, BASF Human Nutrition, Nutricia Australia, Simplot Australia Pty Ltd, King Salmon NZ, Fisheries Research and Development Corp, George Weston Foods, CSIRO Food Futures & Preventative Health Flagships, Croda Australia, Meat & Livestock Australia, Martek Biosciences Corporations, Global Organisation for EPA and DHA (GOED), and Omega3 Learning Consortium.
- NEW Professor Atul Singhal, Deputy Director and head of the clinical trials and cardiovascular nutrition group at the Medical Research Council Childhood Nutrition Research Centre, Institute of Child Health, London and Professor of Paediatric Nutrition at University College, London. He appears in an advertorial on infant nutrition (Australian Doctor, Nov, 2010), sponsored by Nutricia, which is part of Danone Baby Nutrition Asia Pacific and makes infant formulas and supplements.
- Dr Natalie Sinn, from the Nutritional Physiology Research Centre, University of SA was quoted in the same Omega-3 Centre press release as Professor Andrew Sinclair (see above).
- Professor Nerida Smith, Head of School of Pharmacy, Griffith University. Appears in an advertorial for paracetamol sponsored by the makers of Panadol, GlaxoSmithKline. Australian Doctor (11.7.08)
- Dr Morris Snider, Melbourne GP, quoted in an advertorial promoting low calorie diet products for Nestle Nutrition. Australian Doctor (15.8.08; 19.9.08; 17.10.08)
- Professor H. Peter Soyer, Chair of Dermatology, The University of Queensland, Princess Alexandra Hospital, Brisbane. Quoted in an advertorial, sponsored by Inova Pharmaceuticals, promoting Aldara (imiquimod) for treatment of solar keratoses. Australian Doctor (15.8.08; 7.11.08)
- Dr Brian C Sproule, Sydney, quoted in an advertorial promoting Duromine (phentermine), an Inova Pharmaceuticals product, Medical Observer (27.2.2009), Sydney, quoted in an advertorial promoting Duromine (phentermine), an Inova Pharmaceuticals product, (27.2.2009)
- Professor Simon Stewart, Head, Preventive Cardiology at the Baker IDI Heart and Diabetes Institute. Appeared in an advertorial promoting cholesterol treatment commissioned by AstraZeneca. (Medical Observer, July 2009). The close links between the Baker and other pharmaceutical marketing campaigns have been the subject of previous controversy (more info here).
- Professor Eggert Stockfleth, Charite Hospital, Berlin, Germany. Quoted in an advertorial recommending Aldara (imiquimod) for treatment of solar keratoses. Australian Doctor (12.9.08)
- Dr K Tavakoli, plastic surgeon in advertisement promoting “Skin Physics Proton Light Therapy System” for skin rejuvenation. Sun Herald (18.10.2009)
- Associate Professor Frank Thien, Director, Respiratory Medicine, Box Hill Hospital, Melbourne, quoted in an advertorial for allergic rhinitis treatment, sponsored by Schering Plough, in Medical Observer (18.9.2009)
- Dr Gerard V Wain, FRANZCOG, CGO, Director, Department of Gynaecological Oncology, Westmead Hospital, Sydney. “I am the Chair of the CSL Gardasil Advisory Board. I have received speaker fees, travel assistance and consultancy fees from CSL Biotherapies and from Merck and its affiliates in relation to Gardasil. I hold shares in CSL Limited.” Declared in the Medical Journal of Australia here.
- NEW Dr Sarah Weaver, GP, Sydney, is interviewed as part of a two-page advertorial on the treatment of bipolar disorder funded by AstraZeneca (which makes a bipolar treatment) (Medical Observer, 2010). This advertorial ran in the leadup to announcements of an expanded PBS listing for the company’s drug, Seroquel.
Key opinion leaders: Media and community
- Brad McLean, journalist, Medical Observer, attended the American Heart Association Scientific Sessions in New Orleans in November 2008, as a guest of AstraZeneca. This was declared at the bottom of his articles from the conference in Medical Observer (21.11.08).
- Rebecca Jenkins, journalist, Australian Doctor, attended the American Heart Association Scientific Sessions in New Orleans in November 2008, as a guest of AstraZeneca. This was declared at the bottom of her articles from the conference in Australian Doctor (21.11.08). One article described a trial of a lipd-lowering drug made by AstraZeneca, which also makes a number of other drugs for cardiovascular disease.
- Media personality Mikey Robins was the “celebrity spokesperson” for a PR campaign promoting the gastric band for Johnson & Johnson Medical. The campaign won Palin Communications an award from the Public Relations Institute of Australia.
- Cricketer Ricky Ponting features in this campaign for Swisse vitamins. The company, in turns, supports the Ponting Foundation, established by Rianna and Ricky Ponting to raise money for children with cancer and their families and to fund research into childrens cancer.
- Former test cricketer Michael Slater is the face of a new public awareness campaign encouraging diagnosis and treatment of high cholesterol levels. The Age of Your Arteries campaign has been launched by the Australian Atherosclerosis Society in conjunction with AstraZeneca, which makes drugs for cholesterol and cardiovascular disease. An advertisement for the campaign ran in Australian Doctor (28.11.08, 12.12.2008; 23.1.2009, 30.1.2009, 6.3.2009; 13.3.200) and Medical Observer.
- Health journalist Melissa Sweet has in the past taken industry-funded trips: in the 1980s, while at AAP, to Sweden with Astra Zeneca regarding the launch of omeprazole; in the 1990s, while at the SMH, to Germany with a division of Roche to a conference on antioxidants.
Organisations engaged in marketing and awareness raising campaigns or receiving sponsorship
- The Australian Herpes Management Forum aims to “improve the awareness, understanding, diagnosis, management and control of herpes virus infections in Australia”. Its principal sponsors are diagnostic and pharmaceutical companies. The communications firm DDB Remedy won two international awards for the “It’s out of sight but not out of fashion” campaign conducted on behalf of the AHMF to raise awareness about genital herpes. AHMF sponsors are:
Novartis (principal sponsor)
Department of Human Services Victoria
- AHMF Board members are:
Professor Adrian Mindel, Professor of Sexual Health Medicine, University of Sydney, Westmead Hospital
Professor Suzanne Garland, Director of Microbiological Research and Head of Clinical Microbiology and Infectious Diseases, Royal Women’s Hospital, Victoria
Dr Joe Sasadeusz, an infectious diseases physician primarily based at the Royal Melbourne Hospital with cross appointments at the Alfred Hospital and the Melbourne Sexual Health Centre.
Professor Dominic Dwyer, medical virologist and an infectious diseases physician at Westmead Hospital.
Professor William Rawlinson is director of the Virology Division, SEALS Microbiology at Prince of Wales Hospital, Sydney.
Dr Catriona Ooi is Director Sexual Health, Hunter New England Area Health, and has a conjoint academic appointment with the University of Newcastle.
Professor Tony Cunningham, Director, Westmead Millennium Institute and Research Centre, Westmead Hospital, and University of Sydney
- The Baker IDI Heart & Diabetes Institute, for its involvement in a marketing campaign for a Sanofi-Aventis blood thinning medicine clopidogrel (brand name Plavix). The Institute has lent its logo to the drug’s advertising campaign which says:“When you write a Plavix script, Baker IDI & Diabetes Institute benefits too. For every Plavix script dispensed through retail pharmacy in 2009, sanofi-aventis will donate 25c to support their medical research and preventative health programs.”More info about the campaign is here.
- NEW Dietitians Association of Australia has its logo on at least two Kellogg’s advertisements for cereal, which says dietary fibre may reduce the risk of coronary events and diabetes. The advertisements are “supported” by DAA (Australian Doctor, 25 Sept and 3 Dec, 2010)
- Impotence Australia is engaged in awareness and education campaigns around erectile dysfunction, and has featured in treatment marketing campaigns. Its CEO, Brett McCann, was quoted in the Eli Lilly press release promoting Cialis which was found in breach of the Medicines Australia Code of Conduct.Impotence Australia is sponsored by Abbott, American Medical Systems, Gel Works, GlaxoSmithKline, Eli Lilly, Mayne, Mentor, Multi Medical Group, Osbon, and Pfizer Australia.Board members are:
Dr Michael Lowy, sexual health physician, Sydney
Serina Cauchi, a sexual health counsellor
Maria Caetano, a sex and relationship counsellor in private practice.
Dr Ven Tan, Director of three Healthpac Medical Centres in Sydney.
Dr Denis Cherry, a sexual health doctor
- The Influenza Specialist Group runs a public awareness campaign “aimed at educating the community about the potential severity and consequences of influenza and the importance of preventing infection and appropriate treatment”. The Group is funded by CSL Biotherapies, Sanofi Pasteur, Solvay Pharamceuticals, Roche, Novartis Vaccines, Baxter, and GlaxoSmithKline Australia.The Board of Directors is chaired by Dr Alan Hampson, a virologist with over 40 years experience working with influenza. His career includes responsibility for developing influenza vaccine production processes and senior R&D positions (Research & Development Manager) with the Australian biopharmaceutical group CSL Limited, and subsequently as Deputy Director and operational head of the WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, from its designation in 1992 until his retirement in September 2005. Since retirement Alan has maintained an active role both in Australia as a consultant, Chairman of the Australian Influenza Specialist Group (ISG), a member of Australian Government advisory committees on influenza and pandemic preparedness, and internationally with the WHO including membership of its Pandemic Taskforce (now the International Health Regulations Roster of Experts) and Editor in Chief of the international journal ‘Influenza and Other Respiratory Viruses’.The other directors are:Dr John Litt, an Associate Professor in General Practice at Flinders University, and public health physician. He is also the Deputy Chairman of the National Quality Committee of the RACGP. Dr Litt was a cofounder of the SA Influenza and Pneumococcal Advisory Committee in 1993 and conducted the first National Influenza and Pneumococcal Survey in the elderly in Australia in the late 1990s. He is currently chairing the SA Department of Health, Primary care Pandemic Planning Steering committee, a group that is developing a primary care pandemic planning document. Dr Litt has been a member of several committees related to immunisation, including the ATAGI, DOHA Influenza program Advisory Committee, SA Immunisation Forum, SA Influenza and Pneumococcal Advisory Committee
- Clinical Professor David Smith, who currently works in the Division of Microbiology and Infectious Diseases at PathWest Laboratory Medicine WA. He also has appointments as a Clinical Professor in the Faculty of Medicine and the Faculty of Life and Physical Sciences at the UWA, and as an Adjunct Professor in the Australian Biosecurity Cooperative Research Centre at Curtin University of Technology. He is Director of the National Influenza Centre at PathWest, and Co-Director of the Arbovirus Research and Surveillance Group at UWA. He serves on a number of State and Commonwealth Government advisory committees and networks, including the Australian Influenza Vaccine Committee, the Public Health Laboratory Network, the National Influenza Coordinators’ Network, the National Arbovirus and Malaria Advisory Committee, and the Western Australian Influenza Pandemic Action Committee. In addition he is a member of the Asia-Pacific Advisory Committee on Influenza.
- Professor William (Bill) Rawlinson, As a Senior Medical Virologist Professor Rawlinson is head of the Division of Virology, in the Department of Microbiology SEALS, and has a conjoint position in the Department of Infectious Diseases, Prince of Wales Hospital. He has worked previously at the Institute for Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, Addenbrooke’s Hospital (Cambridge U.K.) and Concord Hospital. He has responsibility for a reference diagnostic virology laboratory at The Prince of Wales Hospital, focusing on the assessment and introduction of rapid diagnostic tests. He holds a conjoint academic position as Professor in the School of Medical Science and the School of Biotechnology and Biomolecular Sciences at The University of New South Wales.Ms Kristine Whorlow, Chief Executive Officer, National Asthma Council Australia. She is also an Australian Government nominee on the United Nations Environment Program Medical Technical Options Committee, director and Finance Committee Chairman of the Influenza Specialist Group (Australia) and Management Committee member of the Australian System for Monitoring Asthma.Assoc/Professor Lou Irving (no details provided)
- Dr Rodney Pearce (no details provided)
- MS Australia. According to minutes of the Medicines Australia code of conduct committee, Schering has sponsored this organisation, its state organisations, and at least one of its conferences. The committee held that Schering’s sponsorship of a 2006 MS Australia conference breached the code of conduct, and that “it could be perceived that MS Australia was acting as an agent for Schering whether or not this was actually the case”. A complaint considered by the committee alleged that MS Australia had a history of promoting Schering’s treatment for multiple sclerosis, Betaferon.
- Prostate cancer groups. An Australian company, Minomic International, which has recently launched an international marketing campaign for its upcoming prostate cancer test, is funding a radio and television community services announcement encouraging men to talk to their doctors about prostate health.The campaign, featuring actor Michael Caton, was conceived, produced and directed by Sydney GP and actor Dr Jeremy Cumpston, according to advertisements promoting the campaign in Australian Doctor and Medical Observer (12.9.08 and 19.2.08).The ad, called Make A Date Mate, is being distributed under the auspices of the Prostate Cancer Foundation of Australia, whose website lists among its many corporate sponsors several companies with a direct interest in promoting the diagnosis and treatment of prostate cancer and related conditions.One of these sponsors, Astra Zeneca, has funded a new DVD produced and sold by the PCFA that features Roger Climpson and GP Dr Con Poulos, and aims “to improve understanding and awareness of prostate cancer in the community”.Other sponsors include:Abbott (whose website recommends prostate cancer screening);
American Medical Systems which, amongst other things, sells products for two of the most common side effects of prostate surgery, incontinence and impotence;
- The Stroke Foundation, for lending its name and logo to GlaxoSmithKline advertising campaign for its low dose aspirin, Cartia (the half and full-page adds appeared in Australian Doctor, Pharmacy News, The Weekend Australian magazine in late 2009)
Arthritis Australia was previously included on this list because it was cited in an advertorial promoting the social and economic costs of arthritis that is funded by Boehringer Ingelheim. (Medical Observer Australian Doctor, March 2010). In September 2012, it was removed from the list after advice from Arthritis Australia that the Boehringer promotion was strictly a Boheringer promotion without input/permission from Arthritis Australia.
In response to the promotion, Arthritis Australia made a complaint to the Medicines Australia Code of Conduct Committee, this complaint was considered in April 2010 and, as a result, Boehringer were fined $50,000 and required to print a retraction and apology in Medical Observer and Australian Doctor (June 2010) advising that BI acted inappropriately in using the Arthritis Australia sponsored publication Voice of Arthritis contrary to the wishes of Arthritis Australia.
The registrants respond
We welcome comments from those named on the register — please email us at [email protected]
Monday 15 September
David Colquhoun writes: Thank you for including in your “infamous” Register of Influence. The OMEGA centre is a non profit organisation set up by passionate professionals who sought funding from various industry sources. I have been paid nothing apart from an economy airfare to attend the conference you mention! I am in private practice and lost a day’s work flying to Sydney. I am the chief author of the National Heart Foundation’s Position Statement on Omega 3 Fatty Acids just published on NHFA’s website. It is the most comprehensive review ever with clear recommendations. As old fashioned as it sounds I believe we all have a duty to give back to society. Giving my time free to the NHFA and OMEGA Centre is my contribution — just the Omega paper was hundreds of hours. For the past 25 years I have taught Medical students for free — thousands of hours! Maybe in the public interest you may wish to add this to the details about me. I believe there are many in our world and Australia motivated by more than maximising profit and using others for selfish gain. There are good people out there who care about others sincerely.
Brett Forge, Physician and Cardiologist at West Gippsland Hospital, writes: Many thanks for the dubious honour of being included on your register of influence.
It is an inadequate way of investigating medical corruption but it may at least start a discussion on this vital topic.
The problem is that the medical education agenda has been hijacked by vested interests, particularly the pharmaceutical industry but in other cases it may be equipment or prosthesis manufacturers.
Every doctor is the recipient of drug company sponsored hospitality. This hospitality is lavish but the educational agenda is primarily the attraction. Conferences which provide high quality education are very well attended. The way in which this process to some extent corrupts or influences the doctors attending is subtle but significant as the agenda tends to be focussed on areas for which drugs are effective available and profitable.
The reason for which I was named in your column was for an article about absolute risk. This is an area I have worked in for over 15 years. The result of my research was to develop a risk calculator to help doctors decide when to take drugs for cholesterol and hypertension. The main effect of utilising this tool was to reassure patients that they were actually low risk and did not therefore need to take expensive drugs. In 2001 I undertook a study using the tool which was published in the Medical Journal of Australia. 1 of the conclusions of the study was that up to 60% of people in Australia taking cholesterol lowering drugs were in fact low risk and shouldn’t be taking them, this implied that we were inappropriately prescribing several hundred million dollars of drugs every year in Australia. In spite of the fact that the article and the conclusions were not challenged there was no public discussion about the paper, no interest from government health officers and no invitations for me to discuss my data at meetings. Data suggesting an overuse of expensive drugs does not draw headlines in journals that are funded by drug companies or meetings subsidised by them.
The program that I developed has been downloaded for free by hundreds of doctors in Australia and overseas, but I receive no funding to continue development or research. Needless to say drug companies have no interest in supporting my program nor in inviting me to speak to their conferences as my message is clearly not to their benefit. What is interesting is that some of my learned colleagues have co-operated with the pharmaceutical industry to produce risk calculators that present data in a way that encourages overuse of drugs. These calculators are purchased by the pharmaceutical industry and then distributed to doctors for free.
The advertorial that I was extensively quoted in was in fact stressing this message that proper risk assessment reassures the worried well that they don’t need to take medication.
For your list to take on more meaning it would need to understand and detect a conflict of interest. As I received no income for my contribution to the article nor from selling my program (which is free) and as I receive no income from drug companies I don’t have a conflict of interest. I do receive sponsorship for conferences and payment for speaking to other doctors but this is a tiny part of my income.
I doubt that many of the doctors quoted in your list received remuneration for their comments or endorsement.
Sometimes when I am asked to do an educational talk by a drug company they wish to know what my thoughts are about their product or even to check the content of my talk. Colleagues have told me that they have been told they will not be invited to talk if their attitudes are not supportive of the company’s product. Clearly this is unacceptable but very difficult to detect and expose.
There are however areas of massive conflict of interest where doctors make decisions or recommendations that have large influence both on the practise of medicine and their incomes. Possibly the most glaring example is in the area of interventional cardiology. Interventional cardiology includes the practise of inserting stents into blocked or narrowed coronary arteries. This practise is widespread and probably the single most expensive procedural item on the commonwealth health bill. Guidelines for deploying the procedure are written mostly by the proceduralists themselves who make in some cases over a million dollars per year from this activity.
An example will serve to illustrate the point. A personal friend recently attended a GP with a history highly suggestive of stable angina. He only had chest tightness on exertion and had not started any medication. He was referred to a leading cardiologist at one of Melbourne’s leading private hospitals. Without any discussion he had an angiogram and a stent was inserted into his coronary artery.
The cost of this procedure was $6000 for which he was not covered by insurance.
He was not told by the cardiologist that extensive randomised trials have found that stents provide no survival benefit nor do they reduce the risk of heart attacks. He was also not told that he would be obliged to take 2 antiplatelet drugs for at least 12 months which would expose him to a higher risk of bleeding, and were he to need urgent surgery for an unrelated condition he would be exposed to a very significant risk of having an acute blockage of his stent. The appropriate treatment of this patient is to have active risk factor management and aggressive cholesterol lowering.
Now this is not an isolated example, I suspect it is pretty much standard care, but of course statistics are not readily available on this form of malpractice.
Similarly, guidelines for the management of certain types of heart attacks are strongly in favour of early intervention and stenting. These guidelines are written predominantly by proceduralists and ignore recent evidence that early stenting does not reduce risk. The same can be said for coronary bypass surgery which as an industry is largely being replaced by stenting. The only properly conducted randomised trials into bypass surgery are over 20 years old, showed only small benefit in a subgroup of patients and did not include any of the medical treatments that have dramatically changed the outcome for these patients. These procedures are very useful at reducing angina but many patients are told or believe that they are having it to reduce their risk of death or heart attack.
The history of medicine has many shining examples benefitting mankind and reducing suffering. Parallel to this is the presence of massive profiteering from procedures which appear rational but which are later proved to be of no benefit. Examples include routine tonsillectomy, circumcision, hysterectomys, Caesarean section, radical mastectomy, and prostate cancer screening. However in terms of cost to the community the cardiac interventional industry probably takes the cake.