April 8, 2019

Memorial Sloan Kettering Cancer Center overhauls policies to address conflicts of interest

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    Memorial Sloan Kettering Cancer Center is changing how it evaluates financial conflicts of interest after an independent review found the center's top executives failed to report their financial ties and that the center lacked protocols to assess employees' relationships with corporations, ProPublica and the New York Times report.

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    Memorial Sloan Kettering launches independent review

    The center requested the independent review after a ProPublica and Times analysis last year found top executives at Memorial Sloan Kettering, among other institutions, in recent years had failed to disclose their financial ties to corporate ventures.

    For the review, the law firm Debevoise & Plimpton examined 25,000 documents and interviewed 36 of the center's current and former employees and board members. Mark Goodman, co-chair of the law firm's commercial litigation group, reviewed the findings with the center's employees at a staff meeting last Thursday. ProPublica and the Times obtained a recording of the meeting, but a spokesperson for the center declined to provide a copy of the law firm's findings. 

    Independent review finds 'serious noncompliance' due to limited oversight

    Goodman told physicians the law firm found "a number of instances of serious noncompliance with [the center's] conflict-of-interest policies," although he did not cite specific examples. He noted the center's employees had not intentionally violated the policies.

    Further, according to Goodman, the violations stemmed from the center's inadequate oversight of financial conflicts of interest and the center's failure to implement protocols to examine whether its employees' financial ties could lead to biased research.

    Goodman said the center failed to rigorously vet the financial ties its employees had with corporations and that researchers often did not know when senior executives had a stake in the outcomes of a study.

    According to Goodman, the center in 2014 adopted a new method for evaluating financial relationships. Under that method, a conflict-of-interest advisory committee no longer had to vet the financial relationships of senior executives because the center felt committee members should not be required to make decisions about executives whom they report to, the Times and ProPublica report.

    While Goodman acknowledged the center's reasoning made sense, he said the center failed to formally implement a system to examine potential issues. Specifically, the center did not follow one of its policies requiring that it form a board committee to focus on conflicts of interest.

    "As a result, conflicts were allowed to persist without formal firewalls in place," Goodman said.

    Memorial Sloan Kettering overhauls policies

    Memorial Sloan Kettering on Thursday acknowledged its shortcomings and announced it is taking steps to address them. For instance, the center said it is creating a more centralized review process for potential conflicts of interest and launching a board committee to focus on employees' ties to corporations. The center said it is also planning to disclose its employees' financial ties on its website and place limits on the relationships its employees can have with corporations. The center said it will also conduct regular audits to ensure it is complying with own policies.

    Scott Stuart, chair of the center's Boards of Overseers and Managers, said Memorial Sloan Kettering "took a deep and honest look at what went wrong at our own institution, examined what was occurring in the wider cancer research community, and [is] putting in place best practices that will not only allow us to learn from our mistakes, but will contribute to best practices for the wider research community."

    Reaction

    Walid Gellad, director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, said, the changes the center is implementing to address conflicts of interest appear more comprehensive than the approaches taken at other institutions. Gellad said, "Memorial Sloan Kettering really does seem to be taking this seriously and this document, I think, shows it" (Orstein/Thomas, ProPublica/New York Times, 4/4).

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