MSK's José Basel­ga steps off Bris­tol-My­er­s' board as the in­dus­try de­bates the con­tro­ver­sy over in­dus­try ties

The dam­age re­port from the con­tro­ver­sy sur­round­ing Memo­r­i­al Sloan Ket­ter­ing’s chief physi­cian José Basel­ga keeps mount­ing.

Late on Fri­day came word from Bris­tol-My­ers Squibb that Basel­ga had re­signed from the big biotech’s board of di­rec­tors.

“Bris­tol-My­ers Squibb $BMY is com­mit­ted to the high­est stan­dards of ethics, com­pli­ance and in­tegri­ty,” not­ed the com­pa­ny in a brief state­ment. “These prin­ci­ples are cen­tral to the Com­pa­ny’s mis­sion and our abil­i­ty to de­liv­er in­no­v­a­tive med­i­cines to pa­tients with se­ri­ous dis­ease.”

Basel­ga had on­ly joined the board 5 months ago.

That res­ig­na­tion came sev­er­al days af­ter The New York Times and ProP­ub­li­ca re­port­ed that the renowned can­cer re­searcher had rou­tine­ly failed to fol­low the rules and cite his many fi­nan­cial ties with bio­phar­ma com­pa­nies in jour­nal ar­ti­cles and at con­fer­ences, forc­ing his ouster at Memo­r­i­al Sloan Ket­ter­ing.

Late Thurs­day word spread that the ar­ti­cle had set off a storm of con­tro­ver­sy, trig­ger­ing a chain re­ac­tion of alarm at MSK that prompt­ed the sci­en­tist to turn in his let­ter of res­ig­na­tion. In it, he wrote:

I fear my con­tin­ued role lead­ing clin­i­cal care and re­search will be­come too much of a dis­trac­tion to the hos­pi­tal and its re­mark­able team of physi­cians, re­searchers and staff.

Basel­ga, the once high­ly sought af­ter physi­cian-in-chief at MSK, al­so ac­cept­ed re­spon­si­bil­i­ty for his fail­ures to dis­close his many ties to phar­ma and biotech com­pa­nies, adding that those links were al­so well known and care­ful­ly re­port­ed to MSK it­self.

The news trig­gered a fren­zy of com­ments on Twit­ter, with a mix of views on the sud­den down­fall of a wide­ly cel­e­brat­ed re­searcher. If noth­ing else, it will put a spot­light on the grow­ing fi­nan­cial con­nec­tions be­tween re­searchers and the in­dus­try — and like­ly trig­ger a rush to fill in any gaps on dis­clo­sures in the com­ing weeks.

Quite a few peo­ple felt that forc­ing Basel­ga out at MSK was ex­ces­sive. But it’s al­so clear that prop­er­ly re­port­ing these ties is a se­ri­ous con­cern for the in­dus­try. We put up a poll for peo­ple at the be­gin­ning of the week, and drew more than a few harsh re­bukes for what he had failed to do.

Out of 447 re­spons­es, 330 — 74% — felt his fail­ure to re­port fi­nan­cial ties was a sig­nif­i­cant is­sue. On­ly 26% felt it was not. Sig­nif­i­cant, though, meant dif­fer­ent things to dif­fer­ent peo­ple. 

Here’s a sam­pling of the com­ments we heard:

It’s un­ac­cept­able and un­eth­i­cal. It hurts a lot the al­ready bad rep­u­ta­tion of phar­ma in­dus­try and of all the hon­est peo­ple and ex­cel­lent pro­fes­sion­als who work in clin­i­cal de­vel­op­ment. I am spe­cial­ly touched by his un­eth­i­cal be­hav­ior as I work in phar­ma/CROs and try to do my job as best as pos­si­ble with the high­est eth­i­cal stan­dards I can and have.
Not dis­clos­ing un­der­mines the goal of the en­tire process. The in­for­ma­tion should be pro­vid­ed and avail­able. Whether it in­flu­ences a stake­hold­er’s de­ci­sion one way or an­oth­er is sec­ondary to the fun­da­men­tal dis­clo­sure process. – John Cial­lel­la, Charles Riv­er Labs
Sig­nif­i­cant enough to call him out and have the dis­clo­sures cor­rect­ed but not wor­thy of a ma­jor ex­pose or alarm. He’s not the first or last re­searcher who didn’t dis­close some­thing. Don’t con­done it but lets not over­re­act ei­ther. Just set clear guide­lines and en­force them.
I’d de­fine sig­nif­i­cance as ris­ing to a crim­i­nal, civ­il or eth­i­cal breach. And that breach de­pends on in­tent. It is fair­ly clear that his in­tent was not to de­ceive and this was an over­sight. He made an er­ror. What is much more sig­nif­i­cant was the shod­dy ‘gotcha’ jour­nal­ism that im­plied ma­lign in­tent with­out prov­ing it. – David Weis­man, MD
I don’t think this par­tic­u­lar fail­ure to dis­close con­flicts was sig­nif­i­cant since Basel­ga’s con­sult­ing agree­ments/ad board mem­ber­ships are pret­ty much pub­lic knowl­edge. How­ev­er, this should be a sign to jour­nals, con­fer­ences and oth­er pub­lish­ing en­ti­ties to im­prove their process­es to al­ways en­sure au­thors ad­here to their dis­clo­sure agree­ments. For piv­otal stud­ies, FDA col­lects fi­nan­cial dis­clo­sure forms for all pri­ma­ry in­ves­ti­ga­tors *and* subin­ves­ti­ga­tors, which is sub­mit­ted with the clin­i­cal da­ta.
The re­la­tion­ship of trust be­tween pa­tients and doc­tors is fun­da­men­tal to our med­ical sys­tem. This sys­tem­at­ic fail­ure to com­ply with wide­ly-ac­cept­ed stan­dards of con­flict dis­clo­sure un­der­mines that foun­da­tion, while al­so pro­vid­ing a bad ex­am­ple to younger re­searchers and a good cov­er to un­scrupu­lous re­searchers. Why should any­one dis­close their con­flicts when some­one as ac­claimed as Dr. Basel­ga does not?

Im­age: José Basel­ga. AS­CO

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