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June 27 — Conflict-of-interest allegations from a senator continue to plague an advisory panel that deliberates policies for opioids and other pain medication.
Sen. Ron Wyden (D-Ore.) sent a letter dated June 23 to Health and Human Services Secretary Sylvia Mathews Burwell, in which he followed up on an inquiry into possible financial conflicts of interest on the Interagency Pain Research Coordinating Committee (IPRCC).
The top Democrat on the Senate Finance Committee, Wyden is part of the conference committee that is working out differences with the House on legislation intended to combat the prescription opioid epidemic .
“Americans expect significant transparency when it comes to government policymaking, particularly for an issue like the opioid crisis which is devastating communities in Oregon and across the country,” Wyden said in a June 24 statement. “I’m going to continue to demand accountability to ensure the manufacturers of these powerful prescription drugs aren’t having an undue influence on policies designed to reduce their usage. Halting the opioid epidemic can’t happen until we address the way these drugs are prescribed in the first place.”
The letter follows up on an inquiry Wyden sent in February to Burwell out of concern that some members of the IPRCC received funding from drug companies that manufacture opioids, such as Pfizer Inc., Purdue Pharma and Teva Pharmaceuticals.
Francis S. Collins, director of the National Institutes of Health, responded that the members don't serve as representatives of their organizations but provide input based on their own points of view.
Wyden said he found this assertion “troubling” and asked in the June letter for documentation that IPRCC members reported any conflicts of interest, that federal officials managed those reports properly and that committee members recused themselves.
IPRCC member Richard Payne, whom Wyden mentioned in his letter, told Bloomberg BNA that he disclosed all the past and current research funding, along with an extensive disclosure of his personal investments and 401(k) retirement accounts, as part of the vetting process that occurred before the HHS accepted him for the committee.
“I spent the majority of my career leading pain and palliative care programs in major cancer centers (Memorial Sloan Kettering in New York and MD Anderson in Houston), and the advice and consultations which I provided to government agencies and pharmaceutical companies related to my experience and knowledge in cancer pain assessment and management,” Payne, who is a professor of medicine and divinity at Duke University, said in a June 24 e-mail to Bloomberg BNA.
“I am currently on the faculty of Duke University and am not seeing patients. I do research and teaching in the medical and divinity schools. I do have a part time appointment at the Center for Practical Bioethics in Kansas City. I am aware that in the past the Center has received funding from pharmaceutical companies that market opioids. I believe that this is no longer the case,” Payne said.
When the Centers for Disease Control and Prevention was developing prescribing guidelines for opioids, Payne questioned whether CDC reviewers may have had any possible conflicts of interest. The CDC ultimately approved the guidelines in March .
In his letter, Wyden said these questions indicate that Payne “appeared intent on holding CDC to a much higher conflict of interest standard than NIH has appeared to have done with its own IPRCC panel members.”
Payne told Bloomberg BNA in his response, “I would note the CDC guidelines explicitly exclude cancer patients as a focus for the guidelines. Nonetheless, I have concerns about the potential impact of the guidelines on cancer pain patients, and would add that the American Cancer Society wrote a letter to the CDC expressing similar concerns.”
He added that “I think we need a much more thoughtful and nuanced analysis and management of financial and non-financial conflicts of interest.”
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Wyden's letter is available at http://1.usa.gov/28YbmRH.
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