The latest scandal marks an especially sad failure to meet those ideals. In statements to industry analysts and the American Association for Cancer Research, Dr. Baselga praised two drug trials that many of his peers considered failures, without mentioning that the trials’ sponsor, Roche, had paid him millions of dollars. He also withheld his financial conflicts from dozens of publications, including at least one journal that he edited.
Those conflicts touched his own institution directly, in that several of the companies he advises have business with Memorial Sloan Kettering. Both Varian Medical Systems, which sells the hospital radiation equipment, and Bristol-Myers Squibb, which sells it medications, pay him several hundred thousand dollars a year for his role on their boards of directors. Likewise, Juno Therapeutics and Paige.AI, both tapped Dr. Baselga to serve as a chief adviser after securing exclusive rights to data and technology developed by the hospital. Neither Juno nor Paige are required to disclose exactly what they’ve paid Dr. Baselga, because neither has brought a product to market yet. But if those payments are on par with what he’s receiving from other companies, it would come out to hundreds of thousands of dollars for each. And if his compensation from these companies includes stock, he stands to profit personally, and handsomely, from intellectual property that belongs to the hospital.
Sloan Kettering’s other leaders were well aware of these relationships.
Financial conflicts are hardly confined to Sloan Kettering. A 2015 study in The BMJ found that a “substantial number” of academic leaders hold directorships that pay as much as or more than their clinical salaries. According to other surveys, nearly 70 percent of oncologists who speak at national meetings, nearly 70 percent of psychiatrists on the task force that ultimately decides what treatments should be recommended for what mental illnesses, and a significant number of doctors on Food and Drug Administration advisory committees have financial ties to the drug and medical device industries. As bioethicists have warned and as journal publishers have long acknowledged, not all of them report those ties when and where they are supposed to.
José Baselga, the former chief scientific officer of Memorial Sloan Kettering Cancer Center belongs to an elite group of research doctors who are paid millions for conducting favorable research that pumps specific drugs or medical devices over others that may be more effective and less dangerous. Their research is paid by the pharmaceutical companies, which manufacture the researched drug. It’s hard to imagine such research not being biased or manipulated. These research doctors are akin to lobbyists except they lobby doctors through articles published in the respected medical journal.
However, these research doctors are key revenue makers for teaching hospitals. Their reputation is beyond questioning. Anyone who dares to question their ethics or research face retaliation in the form of employment elsewhere. I’ve seen it happen and heard many stories of whistleblowers whose reputations were destroyed because they sought to make the system honest and ethical.
Doctors like José Baselga, the former chief scientific officer of Memorial Sloan Kettering Cancer Center are beyond reproach at their affiliated teaching hospitals. They may see a select number of patients for a few hours once a week, but everyday patients do not receive care from these elite research doctors who determine the standard of medical treatment. When patients talk about doctors making loads of money from prescribing certain drugs, those are doctors engaged in research for pharmaceutical and medical device companies.
This story shines a tiny light on corruption in medical research. This kind of corruption compromised patient care and led to the opioid crisis, but that’s another story.