Three Harvard psychiatrists, including a leading proponent in the off-label use of antipsychotics for bipolar disorder in children, have been disciplined by Harvard Medical School and Massachusetts General Hospital for not fully disclosing the extent of their ties to drug companies under the federal Physicians Payment Sunshine Act of 2010. Drs. Joseph Biederman, Thomas Spencer and Timothy Wilens are said to have accepted more than $4.2 million from drug companies including Johnson & Johnson for psychiatric research and other activities between 2000-2007, and not reporting the income to Harvard, MGH or the federal government.
According to NPR, back in 2008, the doctors’ undisclosed industry payments were brought to light when Sen. Charles E. Grassley (R-IA) reported discrepancies between what various drug companies said they paid them, and what the doctors themselves reported to Harvard and the MGH.
All three doctors have “published extensively” on ADHD in children and adults. Further, Biederman (the most senior in rank as he’s a full professor at Harvard), is a leading voice in using powerful antipsychotic drugs to treat bipolar disorder in children. As NPR says, “his work is widely seen as contributing to an explosive growth in such prescriptions, and much of his support came from companies that benefited from his research.”
The three doctors are now barred from accepting payments for “all paid industry-sponsor outside activities” for one year, after which they must seek approval ” before engaging in any “paid activities” and report to Harvard and the MGH on those activities for an additional two years.” They must also attend training on conflict-of-interest and will be subjected to “a delay of consideration for promotion or advancement,” a penalty that falls especially harshly on Spencer and Wilens, who, as associate professors, are both of lower rank than Biederman.
Biederman, Spencer and Wilens detailed their “mistakes” in a “Dear Colleagues” letter made available to “selected reporters” by MGH. As they wrote:
“Our mistakes were honest ones. We always believed that we were complying in good faith with institutional policies. We now recognize that we should have devoted more time and attention to the detailed requirements of these policies and to their underlying objectives.”
As NPR points out, Harvard and MGH have issued only “vague statements” about the investigation into the three doctors and the nature of the violations. The National Institutes of Health, which had provided grant support for the doctors’ work, did not reveal whether it had ever itself conducted ”an investigation on the matter or whether one has been concluded.”
The “lack of sunshine” from Harvard, MGH and the NIH is disappointing. Many believe that too many children today are being “treated” with medications including antipsychotics and debates are raging about the over-diagnosis of ADHD, ADD and also bipolar disorder in children. You can read about plenty of conspiracy theories about doctors getting payola from “Big Pharma” in return for giving kids diagnoses that then “require” medications made by said drug companies.
What gets lost in the debates and mudslinging is that there are kids out there with very real conditions (including my son) for whom medications offer real help. Indeed, the right combinations of medications in the right dosages under the care of a physician whose goal is actually helping kids rather than shoring up their bank accounts — the right medications can greatly help kids and even make a difference between institutionalization and a child living at home with his family. Will the convictions of the three Harvard doctors only erode trust in child psychiatrists and the medical profession, so that families turn to unregulated alternative practitioners and are even more in the dark about what’s behind “treatments” (not to mention those who dole out the “treatments”) for children with complex needs?
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