Cleveland Clinic’s Topol Severs Ties to Health, Drug Companies To Prevent Conflicts of Interest

In response to recent concerns about conflicts of interest among medical researchers, Eric Topol, chief of cardiovascular medicine at the Cleveland Clinic, is sending letters to drug and other health care companies to end his consulting agreements and ask that his name be removed from their corporate materials, the New York Times reports. The move follows a report in Fortune magazine in December 2004 that Topol was a paid consultant for a hedge fund that had profited from betting on the decline in Merck's stock following the company's withdrawal of Vioxx from the market. According to the Times, Topol "had been a vocal critic of Vioxx." At the time, Topol said he was unaware of the fund's position on Merck and was not an investor in the fund. To avoid potential conflicts of interest, he decided to end his financial ties with the fund, "other financial concerns" and medical companies, including the Medicines Company, DeCode Genetics, Eli Lilly, Bristol-Myers Squibb, Sanofi-Aventis, PharmaNet, Creative Clinical Concepts, CardioMEMS and CardioNet, the Times reports. In one letter to a medical company, Topol said, "I want to ensure that my own and the institution's academic integrity as its chief academic officer remain beyond even any appearance of a perceived conflict of interest."

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Topol said he still plans to participate in health company-sponsored clinical trials at the Cleveland Clinic, for which the institution receives payment, and he also plans to collaborate with drug and device companies without compensation to remain on top of advances in medicine. He also said that his decision to sever ties was not solely prompted by reports of his relationship with the hedge fund, as he had been considering doing so for a long time. Topol said he believes a decision by NIH to prohibit top officers from entering into consulting relationships with medical companies "is something that should be done across all academic medical centers." He added, however, that he does not believe other Cleveland Clinic researchers should sever all financial arrangements with health care companies, noting that he has an especially sensitive position as chief academic officer of the institution.

Cleveland Clinic's Conflict-of-Interest Guidelines
According to the Times, officials at the Cleveland Clinic are developing new conflict-of-interest guidelines that "will strongly discourage researchers from having any relationships with Wall Street funds, as opposed to medical companies" (Pollack, New York Times, 1/25). As "one of the most entrepreneurial and prestigious medical institutions in the country," the Cleveland Clinic has "in recent years become the epitome of Medicine Inc., where doctors and researchers are encouraged to develop new drugs, devices and medical treatments," and financial ties "abound," the Times reports. The new rules would not prohibit financial relationships but instead would ask researchers to disclose their ties to minimize the impact of potential conflicts. Under the proposed changes, the amount of financial benefit that would set off a review of potential conflicts of interest would be lowered from $25,000 to $10,000, and the clinic's Institutional Review Board would take a more active role. If a conflict of interest is found, the clinic would propose a separate review process that would include members of the board. The clinic also has instituted a policy of having statisticians or outside specialists review data from studies that involve researchers with potential conflicts of interest (Abelson/Pollack, New York Times, 1/25).