Wednesday, October 3, 2018

Memorial Sloan Kettering angers stakeholders with tepid crisis response

Consumer trust is important in any industry. In health care, it’s essential.

Scandal has rocked Memorial Sloan Kettering Cancer Center, one of the nation’s leading oncology facilities, shredding that trust. Its chief medical officer failed to disclose millions of dollars in incentives and kickbacks he had received from pharmaceutical companies.

ProPublica reported:

The researcher, Dr. José Baselga, a towering figure in the cancer world, is the chief medical officer at Memorial Sloan Kettering Cancer Center in New York. He has held board memberships or advisory roles with Roche and Bristol-Myers Squibb, among other corporations; has had a stake in start-ups testing cancer therapies; and played a key role in the development of breakthrough drugs that have revolutionized treatments for breast cancer.

According to an analysis by ProPublica and The New York Times, Baselga did not follow financial disclosure rules set by the American Association for Cancer Research when he was president of the group. He also left out payments he received from companies connected to cancer research in his articles published in the group’s journal, Cancer Discovery. At the same time, he has been one of the journal’s two editors in chief.

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The disclosure creates a problem for patients who are left to wonder whether their course of treatment is influenced by a backroom deal with a drug company.

Steven Petrow, a former patient and now a volunteer for the hospital, has shared his dismay over how leaders have handled the crisis.

He writes :

I trusted Memorial Sloan Kettering Cancer Center and believed in it. For more than 30 years, my family and I have literally put our lives in its hands. But it has betrayed my trust and that of many other patients and their families.

Leaders have attempted to address financial disclosure within the hospital—and, they hope, salvage its public status. A letter was sent to MSK employees and stakeholders, reading in part:

The issues surrounding author disclosures are complex, as there are nebulous guidelines about when and how to make voluntary disclosures. We believe in supporting academic freedom and the ability of individual researchers to engage in the scientific process, including publication of results. This extends to judgement exercised by individual researchers and their responsibilities as authors with regard to disclosure.

Petrow finds the statement lacking.

With all due respect, I think an institution that can so ably tackle the complexities of cancer ought to be able to master disclosure requirements.

Here’s why these conflicts matter: Patients like me, my mother and sister, and thousands more have literally put our lives on the line when we trust that a treatment protocol is the very best available. A seed of doubt now exists: Could those recommendations be colored by a physician’s extra-curricular financial entanglements?

Disclosure concern has become a rolling crisis for the hospital, with leaders looking to eschew such affiliations and undo the damage.

ProPublica reported:

A vice president of Memorial Sloan Kettering Cancer Center has to turn over to the hospital nearly $1.4 million of a windfall stake in a biotech company, in light of a series of for-profit deals and industry conflicts at the cancer center that has forced it to re-examine its corporate relationships.

The vice president, Dr. Gregory Raskin, oversees hospital ventures with for-profit companies. As compensation for representing the hospital on the biotech company’s board, Raskin received stock options whose value soared when the startup went public a little over a week ago.

Another memo to MSK workers announced a new policy for financial ties with startups and drug companies.

It read in part:

Effective immediately, we have implemented a moratorium on appointments of MSK board members to serve on the boards of MSK start-ups or to make any direct investments in them. Additionally, we intend to codify, as standard policy, that any potential equity that could be attained by employees appointed as MSK-designees to outside boards will be returned to the institution and dedicated to research.

These changes are a product of the feedback we have received from staff, our re-examination of our processes, and additional information that has come to light from outside reporting. The moratorium is in place while the recently announced task force examines policies around transparency, reporting and outside activities and develops a broad set of recommendations upon its conclusion. But we decided today’s actions should be taken immediately.

Hospital board members have also spoken out.

The New York Times reported:

The remarks by Douglas A. Warner III, the chairman of the center’s board of managers and overseers, as well as Dr. Craig B. Thompson, the chief executive, went beyond previous hospital statements about the former chief medical officer, Dr. José Baselga.

[…] “I have to say, while we pushed back on a lot and discussed a lot, we were not as effective as we should have been,” Mr. Warner said, according to a preliminary transcript of a meeting with the hospital’s staff that was inadvertently emailed by the hospital to a reporter for The New York Times. “He crossed lines that we should have done more to stop.”

However, it seemed that the outspoken board member and the hospital’s communications team weren’t exactly on the same page.

The New York Times continued:

Christine Hickey, a hospital spokeswoman, said: “Dr. Baselga resigned, he was not fired. Mr. Warner was making the point that we had no choice but to accept his resignation.”

She also said Mr. Warner and Dr. Thompson were referring not to his ties to outside companies but to a “conflict of commitment.”

“Dr. Baselga wanted to take on more, join more boards, be involved in more outside efforts,” she said. “He was overextended.”

In addition, Sloan Kettering’s CEO is leaving the boards of two pharmaceutical companies, including Merck.

The New York Times reported:

Dr. Craig B. Thompson, the chief executive of Memorial Sloan Kettering Cancer Center, said Tuesday that he would resign his seats on the boards of drug maker Merck and another public company, the latest fallout from a widening institutional reckoning over relationships between cancer center leaders and for-profit health care companies.

Dr. Thompson has served on the board of Merck, the maker of the blockbuster cancer drug Keytruda, since 2008. He has been on the board of Charles River Laboratories, a publicly traded company that assists research in early drug development, since 2013.

Moves to part with Baselga and other hospital leaders who took money from biotech companies may eventually repair Memorial Sloan Kettering’s reputation—but the damage has been severe.

Petrow concludes:

Memorial Sloan Kettering has long touted in ad campaigns that it provides “the best cancer care anywhere.” My family agrees. But every news article about what is rightfully being described as a crisis at the center deepens our sense of betrayal.

What do you think of the hospital’s crisis response, PR Daily readers?

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