Healthy Skepticism Library item: 14714

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Publication type: news

Silverman E.
Goodwin: Pharma Ties Have ‘Never Been A Secret’
Pharmalot 2008 Dec 1
http://www.pharmalot.com/2008/12/goodwin-my-pharma-ties-have-never-been-a-secret/

Full text:

Former National Public Radio host Fred Goodwin is the subject of a great deal of talk these days. Earlier this year, an episode of his program, “The Infinite Mind,” which was heard on 300 NPR stations, featured three experts who discussed the controversial link between antidepressants and suicide. All of them, plus Goodwin, declared that worries about the drugs have been overblown.
Yet the trio’s ties to pharma were never disclosed. Then, 10 days ago, Chuck Grassley, the ranking Republican on the US Senate Finance Committee, revealed that Goodwin, a former director of the National Institute of Mental Health, also has substantial ties to several drugmakers. Since 2000, Glaxo, for instance, paid him more than $1.2 million in speaking fees and over $100,000 in expenses.
The story, which was first reported here on Pharmalot (look here) and shortly afterwards by The New York Times, received tremendous attention as an example of what industry critics say are undisclosed conflicts of interest and unchecked pharma influence. NPR, itself, covered the story late last week after yanking the show (listen here). Meanwhile, the show’s independent producer, Bill Lichenstein, maintains Goodwin never disclosed the full extent of his pharma ties (look here).
A few days ago, Goodwin, who co-founded a consulting firm that Grassley is also now investigating, circulated a cheeky reply to the controvery and the Times article, in particular. His response, some of which doesn’t quite match some info given by Glaxo to Grassley, made its way to the chat room at the American Psychiatric Association. Here it is…
The Times “article is filled with misstatements of fact and nasty innuendo, the latter achieved by the clever sequencing of unrelated facts. Let me first note that I spent nearly an hour on the phone with (Times reporter Gardiner) Harris, and I followed this up with a detailed email; providing easily verifiable factual information. While he did quote a few things I said, all of the important information I provided was left out of the story. Why? It’s clear now that when we talked he already knew what he was going to write and the information I provided simply didn’t fit his narrative. Had he included all of the relevant facts he would not have had a story that would have gotten by any competent editor.
“Some of his misstatements of fact about The Infinite Mind have been covered in other media reports (NPR, 11-26-08.) I’ll focus on his most egregious misstatements and omissions. His story implied that I am and was always the host of The Infinite Mind. In fact from April ‘05 through January ‘08 the producer replaced me with another psychiatrist with no ties to drug companies, while I served as guest host for shows unrelated to pharmacological treatment issues.
“His story also implied that I had been a speaker for GlaxoSmithKline since 2000. My speaking for GSK started in January ‘04 with talks dealing with lithium. Incidentally I saw this as an opportunity to remind psychiatrists about this forgotten drug; forgotten because it’s been generic for decades and doesn’t make enough money to justify it’s promotion by drug companies. I referred him to Manic Depressive Illness 2nd edition, where my views on the dismaying fact that many young psychiatr ists don’t use lithium are clearly expressed. Later, as Lamictal joined lithium as the only other FDA approved mood stabilizer, my talks included the FDA indications for both.
“More egregious is Harris’ Paxil narrative. The story line was that the March ’08 Infinite Mind show that I hosted criticized the FDA warning about suicidality and SSRI’s (such as Paxil) because I was carrying water for GSK which makes Paxil. In fact, had he listened to the show (or had searched the topic on the web) it would have been clear that my real concern, along with many of my colleagues, was the vagueness of the concept of ’suicidality,’ a term never properly defined or validated.
“I was concerned that such language implied that ’suicidality’ was a predictor of actual suicide, an association which is tenuous at best. (Suicidality encompasses everything from suicide attempts to suicidal thoughts, to any ’self harm,’ much of which has no relationship whatsoever to suicide). My concern was straightforward: this black box warning might scare many doctors away from using these drugs, for fear of being sued (suicide being the number one reason why psychiatrists are sued).
“Doctors should be warned about the distressing symptoms that young patients can sometimes feel on these drugs, but a lot of us feel that a less charged word should have been used. Mr. Harris ignored all of this because it didn’t fit his narrative. Furthermore, when Harris quoted the show’s script as asserting ‘that there is no scientific evidence linking SSRI’s to suicide,’ rather than challenging the accuracy of that statement (which he couldn’t do) he fell back on a nasty inference: that our conclusion reflected bias because of my connection to GSK! That’s about as shoddy as journalism gets.
“Also undermining Harris’ narrative is my long-standing, easily accessible record of being quite critical about the overuse of SSRI’s, especially in young people. I referred him to the treatment of depression chapter in my 2007 book (with KR Jamison) on manic depressive illness and gave him references to two recent journal articles I co-authored, which expressed major reservations about the overuse of SSRI antidepressants. I further pointed out that I had never spoken on behalf of Paxil. All this information was ignored.
“Most egregious was the typical tabloid ‘guilt by association’ ploy in which he implied that I somehow knew that GSK had been accused of suppressing data on Paxil and suicidality when we did the show on SSRI’s and suicidality! Of course he has no evidence whatsoever to back that up; he was simply engaging in a cheap-shot, sleazy, indirect form of libel characteristic of tabloid journalism at its worst.
“Second, his ‘bipolar disorder in kids as a promotion of Lamictal narrative;’ I pointed out to Mr. Harris that Lamictal has not yet been properly studied in that age group. Mr. Harris apparently didn’t listen to the show, which, as I recall, did discuss mood stabilizers that have been studied in kids, especially lithium and divalproex, both now generic drugs and no longer ‘promoted’ by anyone. (Additionally, I also pointed out that Paxil had been generic for some time and was no longer promoted).
“Incidentally, I was surprised to find out that Mr. Harris, as a ’science writer’ for a major newspaper did not seem to know even the simplest background information about drugs that were relevant to a story that he was writing.
“Third, his narrative that my involvement with pharmaceutical companies was ‘undisclosed.’ Again, Mr. Harris simply ignored what I told him (and didn’t bother to do a simple web search) – that there is ample evidence in the public record disclosing my work with drug companies; it’s never been a secret. It’s extensively acknowledged in papers that I have published, in my book, and in all of my continuing medical education (CME) activities. A real reporter would have checked these things out.
“I also told him that The Infinite Mind producers were aware of my connections to pharmaceutical companies although I acknowledge that Mr. Lichtenstein may not have known all of the details. While he did quote me in the ar ticle to this effect, he failed to cite an important, easily verifiable fact: Mr. Lichtenstein recruited another psychiatrist without any ties to industry to be the host starting in 2005, and serving through January 2008. This action was taken to deal with Mr. Lichtenstein’s concern that my industry ties could become a problem for the program. Indeed, it is worth noting that during most of the time I was giving promotional talks for GSK, I was not the host of the program. Again, an interesting fact that would’ve taken some of the ‘juice’ out of Mr. Harris’ breathless narrative.
“With respect to the dispute over whether Mr. Lichtenstein was generally aware of my activities, I have been contacted by a former producer of the program who was very upset with Mr. Harris’ story, especially Mr. Lichtenstein’s apparent denial of knowledge about my pharmaceutical company contacts. She sent me a copy of her letter to the Times and if and when they publish it, it will be clear who’s telling the truth:
“The recent NYT article of 11/21 reports that during the time Dr. Fred Goodwin hosted the public radio program “The Infinite Mind,” he also earned fees from pharmaceutical companies for consulting and speaking engagements in which he promoted their drugs. According to the article, the program’s creator and executive producer Bill Lichtenstein says he was “unaware of Dr. Fred Goodwin’s financial ties to drugmakers.” For over two years, beginning in 2001, I was a staff producer for “The Infinite Mind.” I would be surprised if Bill Lichtenstein was entirely “unaware” of Dr. Goodwin’s work for pharmaceutical companies. When I worked there, the program’s series producer told me about Dr. Goodwin’s consultation and speaking fees on behalf of pharmaceutical companies, and that she, Bill Lichtenstein, and Dr. Goodwin had discussed how to manage and avoid a conflict of interests.”
UPDATE: Here is a note from Bill Lichenstein: “The fact is, Senator Grassley’s charges are about Goodwin personally taking at least $1.3 million to speak on behalf of a company, GSK. And that is something I was unaware of until I got the call from the New York Times reporter on November 20, 2008. I still can’t tell you the details of a single speaking engagement, location, date or time, or venue.” Again, for a comment he posted on the NPR site, see this link.