For context, please refer to the original article here.
Medicine is no stranger to conflicts of interest, however the exposé of healthcare startup Page.AI’s partnership with Memorial Sloan Kettering (MSK) presents unique possibilities of compromises of quality of care and patient privacy. MSK physician Dr. Lisa DeAngelis issued a response in support of MSK’s investment in Page.AI, arguing that collaboration between healthcare institutions and startups catalyzes research advancements and improved patient outcomes. Summarizing her defense, she states “When [these partnerships] yield profit, the investors profit. But patients gain even more” (DeAngelis, 2018). Patients then should fully trust and applaud all corporate partnerships in the name of advancement, right?
History has demonstrated DeAngelis’s tidy quip not to be airtight. She supports her argument by declaring how “breakthrough after breakthrough has come from work with pharmaceutical companies” (DeAngelis, 2018). While we may have such collaborations to thank for some of our most important medications, we cannot ignore egregious cases where conflict of interest harmed patients. Individual cases can aggregate into public health crises like America’s current opioid dependency. When physicians initially began to report addictive symptoms with prescriptions of OxyContin, Purdue Pharmaceutical representative Dr. David Haddox published in 1989 that each “misunderst[ood pseudo-addiction] lead[ing] the clinician to inappropriately stigmatize the patient with the label ‘addict,’” (Keefe, 2018). An unpublished study conducted by Purdue Pharma the same year demonstrated that the labeled span of relief was over projected (Ryan, Girion, & Glover, 2016). After withholding this information, Purdue Pharma and their investors continued to relieve pain, promote addiction, and produce billions of dollars. They did this with doctors’ help, sponsoring all-expense paid vacations if the physicians praised OxyContin at pain management conferences (Keefe, 2018).
Prioritizing profit over patients through involvements with pharmaceuticals has been known not only to promote addictive drugs but may also hinder promising drug development. Considering the expense and resources demanded by drug research and development, many pharmaceutical companies are disinterested in repurposing blockbuster drugs for alternative usages or designing new compounds (O’Hara & Dunkin, 2016). Call it corporate greed or business savvy, these companies have their own interests. It would be unreasonable in our market to expect their priority as a business to always align with patient interests. MSK’s sponsorship of Page.AI may cloud executive board judgement and sway the principles in the MSK mission statement: “to lead…through programs of excellence, education, outreach, and cost-effective patient care.” Not only did executive board members invest hospital stake in Page.AI, calling its non-profit status into question, but some members compounded this by personally backing the startup as well.
DeAngelis’s statement completely ignores possible privacy violations that could arise with surrendering patient data to a third party. Patients were not given the ability to provide consent that their cell samples were able to assist development of a third party’s artificial intelligence program. Steps to de-identify data can be undone, revealing identities behind images.
There is truth within DeAngelis’s claims. Without trust in the establishment and business to market research results, many treatments would remain inaccessible. However, her blanket assertions discouraging wariness about conflicts of interest and privacy violations dismisses history and threatens patient welfare.
Edited by Jin Yoo.
DeAngelis, L. (2018, October 23). Opinion | Your Doctor Needs Your Trust. Retrieved February 12, 2019, from https://www.wsj.com/articles/your-doctor-needs-your-trust-1540335833
Keefe, P. R. (2018, November 26). The Family That Built an Empire of Pain. Retrieved from https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
O’Hara, M., & Duncan, P. (2016, January 27). Why ‘big pharma’ stopped searching for the next Prozac. Retrieved February 5, 2019, from https://www.theguardian.com/society/2016/jan/27/prozac-next-psychiatric-wonder-drug-research-medicine-mental-illness
Ryan, H., Girion, L., & Glover, S. (2016, May 5). ‘You want a description of hell?’ OxyContin’s 12-hour problem #InvestigatingOxy. Retrieved February 5, 2019, from https://www.latimes.com/projects/oxycontin-part1/
Tribble, S. J. (2018, June 29). The potential for conflict of interest when health policy experts also serve on the boards of pharma companies. Retrieved February 5, 2019, from https://medcitynews.com/2018/06/pharma-companies-and-conflict-of-interest/