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Clinical Trials

Pecunia Non Olet?

Today’s New York Times had a long front-page story from Janet Roberts and the paper’s Scourge of the Drug Industry, Gardiner Harris. Titled “After Sanctions, Doctors Get Drug Company Pay”, it details (through the example of one particular Minnesota psychiatrist) a practice of physicians who have had medical board problems continuing to get money for participating in clinical studies.
Dr. Faruk Abuzzahab has definitely had his run-ins with the medical authorities. And over the years he’s also definitely had payments from various companies. It’s not a story to make you feel warm and fuzzy, that’s for sure. There are some things about it that puzzle me, though. For one thing, it appears that Abuzzahab is no bargain as a clinical investigator:
“Separately, the F.D.A. in 1979 and 1984 concluded that Dr. Abuzzahab had violated the protocols of every study he led that they audited, and reported inaccurate data to drug makers. He routinely oversaw four to eight drug trials simultaneously, often moved patients from one study to another, sometimes gave experimental medicines to patients at their first consultation, and once hospitalized a patient for the sole purpose of enrolling him in a study, the F.D.A. found. . .
A simple Google search reveals Dr. Abuzzahab’s 1998 medical board disciplinary file, which was reported at the time by a local newspaper and a TV station. In 1998, The Boston Globe featured Dr. Abuzzahab in a front-page article questioning the safety of psychiatric drug experiments. And in 1999, the NBC program “Dateline” did a segment about a woman who committed suicide while in a drug experiment he supervised.
In June 2006, the medical board criticized Dr. Abuzzahab, this time for writing narcotics prescriptions for patients he knew were using false names, a violation of federal narcotics laws.
Despite all this, drug makers continued to hire him. Dr. Abuzzahab’s résumé lists 11 publications or research presentations since 2000, when the medical board lifted its restrictions on his license.”

Well, I haven’t seen the guy’s résumé, but a PubMed search shows only one paper since that year, and only one other since 1983. His publication record thins out drastically after the early 1980s; this is not someone who cares about blazing across the sky of the scientific literature.
What exactly does he care about, though? Money? According to the graphic that accompanies the story, Abuzzahab received $55,000 from several drug companies over an eleven-year period. That’s better than a kick in the ankle, but it doesn’t seem like enough cash to turn a busy psychiatrist’s head, either. I’ve not had the opportunity to find out if I can be bought or not, fortunately, but I can tell you this: it would take more than five grand a year to do it.
And just what is it that GSK, Wyeth, J&J and the other companies who’ve paid him are hoping to get? The first thought is that they’re hoping to influence his prescribing habits, because it doesn’t sound as if the clinical data he’s generating are worth all that much. Is that amount of money enough to do it? Presentations by a well-known and well-respected figure could also be expected to influence the scrip-writing of others, but Dr. Abuzzahab doesn’t seem, in recent years, to have been that kind of person.
No, this sort of thing doesn’t look good at all. The Times story gives a reader the impression that companies are disproportionately funding physicians with disciplinary problems, although there’s no evidence to back that up. But the funding should be disproportionate in the other direction, which doesn’t seem to be the case. Not good, not good at all.

5 comments on “Pecunia Non Olet?”

  1. david says:

    This is what happens when you have MBAs running marketing groups. I doubt this would be happening if a physician were running the operation. Does Novartis do this?

  2. Still Scared of Dinosaurs says:

    So the MD’s on the medical board allow him to keep treating patients but it’s the fault of MBA’s that he’s still working on drug trials?
    And on top of that FDA doesn’t blacklist the guy? He violates federal narc laws without prosecution? Lotta failure going around here.
    Which is not to say that pharma business model crap isn’t part of the problem. You ask what they get out of working with this guy? Accrual. It’s the primary bottleneck in the conduct of most trials, and the compromises and mistakes we make always come back to haunt us. “Haunt” in my case involves a lot of programming and documentation to defensibly clean up the data to some sort of interprebility, though in the case of someone like Dr. Abahazmatsuit that’s pretty easy because we just write a sentence in the CSR saying we excluded it.

  3. Jamie Singer says:

    One of the physicians mentioned in the article, Barry Garfinkel is banned from running clinical trials according to FDA’s posted list of disqualified Investigators.
    The underbelly here are these paid drug talks- the physican sells his/her soul and reads the company marketing slides to a group of physicans that showed up for the free dinner.

  4. Mark Eccles says:

    “The Times story gives a reader the impression that companies are disproportionately funding physicians with disciplinary problems, although there’s no evidence to back that up.”
    Dr. Barry Garfinkel
    Dr. Garfinkel
    Dr. John Simon
    Dr. Ronald Hardrict

  5. Eric says:

    I have been a patient of Dr. Abuzzahab since 1990.
    I am a very special case. I have TBI and depression. Alot of medication doesn’t work on me and that is why I volunteer for medical studies. Dr. Abuzzahab has tried every medication on me. When I had a bad reaction to a medication he would take me on the medication. He has treated with me with respect and he has taken very good care of me. He cares about people and wants to help people. He sent me to Menninger Clinic, Mayo Clinic, and The Courage Center for second opinions. The Drug Companies pay him big money for doing medical studies. I never got paid for volunteering for a study. I think Dr Abuzzahab is not greedy and some doctor has to do the studies. It is my opinion that he is not reckless. Now he is in private practice.

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