Wednesday, December 17, 2008

The Incredible Vanishing Key Opinion Leader

Charles Nemeroff, former chair of psychiatry at Emory University and key opinion leader extraordinaire has vanished. Not quite vanished from the face of the Earth, but from Medscape CME and now from a Georgia mental health commission. Nemeroff was found to have not disclosed a whole boatload of money he received from Big (and little) Pharma according to an investigation by Senator Charles Grassley. For example, it appears that Nemeroff received about $20,000 in cash from GlaxoSmithKline in one month in exchange for promoting GSK products to his peers.

I have previously written about a number of, um, "interesting" behaviors on the part of Nemeroff, which I recommend you read in order to understand that Nemeroff has, on several occasions, engaged in behavior that certainly appears to have placed the causes of his corporate sponsors over science. Not good for an "independent" researcher.

And now, it seems that Chuck Nemeroff is vanishing. Dr. Bernard Carroll noted that Nemeroff's continuing medical education offerings had vanished from Medscape and offered the following:
Well, good for Medscape. They came in for their share of criticism, here and here, a while back. Now they deserve credit for displaying ethical standards. Meanwhile, we are waiting for another company called CME Outfitters to get the message. Dr. Nemeroff is slated to moderate a raft of new programs for this company in the coming weeks, sponsored by corporations like Pfizer, AstraZeneca, and Ortho-McNeil Janssen. CME Outfitters' logo, after all, is Education with Integrity. Sooner or later the pharmaceutical corporations, like the CME companies, will understand that they are not helping themselves by trotting out a shopworn and sleazy KOL figurehead like Nemeroff for their marketing efforts. And other KOLs who up to now were willing to "wet their beaks" in these CME forums controlled by the Boss of Bosses Nemeroff will now be leery of associating with him.
Well, CME Outfitters is still rolling with Nemeroff. For example, he has an upcoming program called "Atypical Antipsychotics in Major Depressive Disorder: When Current Treatments Are Not Enough," which is a scary thought given that he appears to have been pulling data from thin air for a prior CME exercise in which he pimped risperidone as a treatment for refractory depression. Specifically, Nemeroff's presentation claimed that risperidone improved sexual function in a clinical trial, when the published article based on the trial's results said no such thing. In addition, Nemeroff's claim that risperidone had shown efficacy in a short-term study versus placebo for depression was also unsupported. So I'm thinking the upcoming program on antipsychotics for depression might be a fantastic example of marketing beating the crap out of science.

Georgia appointed a commission to address several issues within the public mental health system. They have completed a report. Interestingly...

The final version also does not contain the name of commission member Charles Nemeroff, an Emory psychiatry professor who has been a subject of a U.S. Senate Finance Committee investigation into whether drug company money paid to doctors and academics compromises medical research and scholarship. Nemeroff, an internationally known expert on depression, did not attend recent commission meetings.

But Nemeroff was appointed to the commission with some fanfare. The press release listing Nemeroff's accomplishments is pretty lengthy. The Georgia state legislator who appointed Dr. Nemeroff said, "I am confident that Charles will be an asset to this commission and will serve as a strong advocate for the people of Georgia being served [by] our mental health systems"

Yet Nemeroff was not on the final report. If it weren't for his work on CME Outfitters, I would be worried that we might need to file a missing persons report for Dr. Nemeroff.

Update (12-18-08): The Wall Street Journal Health Blog has two interesting posts on Dr. Nemeroff (1, 2). Read them and feel free to file them under "bizarre."

7 comments:

therapyfirst said...

I really gave this a lot of thought before offering the following in this comment, but in the end, I feel it fits. So, here it is for consideration and dissection:

I truly feel people like Nemeroff have gone beyond narcissism and selfishness and approached the boundaries of sociopathy in shamelessly promoting medications that do not have a level of efficacy worthy of the level of promotion these drug companies have tried to literally force down the throats of a naive, over-trusting public. Specifically, antipsychotics have no true legitimate place in consideration for treating a sizeable percentage of unipolar depression or anxiety disorders, and their level of efficacy in treating mania even has limits. And this is being offered by a psychiatrist who has been practicing for 15 years, working the last 5+ in community mental health where a sizeable population of legitimately diagnosed bipolar patients are seen.

I do not know what is worse in the end: these shameless greedy Judases who have a level of authority and respect as alleged leaders in the field who have whored themselves out to profit driven organizations, or the clueless and noninvested cowards of peers who accept these false words of authority and direction in considering the recommendations for these meds to be considered for applications that as recent as 5 years ago would be outwardly rejected and scorned as possible treatment interventions for the above diagnoses.

Don't count me in this above grouping. I treat individuals, not cookie cutter diagnoses that diminish the value of my field when recklessly applied.

Thank you for the opportunity to comment here. Nice posting!

Anonymous said...

I'd like to propose we call such blatant COI, or as in this case, fraud, a "Nemeroff", as in "He announced he takes payment for speaking engagements in mountain resorts on behalf of pharma, but bristles at this being called COI. "It's not as though I did a Nemeroff."

Radagast said...

So, The Nematode's disappearing, is he? Bambleburg, at Harvard, next, with a bit of luck!

I can't believe that The Nematode's going to be subjected to completed non-existence, though, or, if he is, then there'll be another like him to take his place. Pharmaceuticals aren't what's required to deal with the issue known as "mental illness," but as long as there's a vested interest in putting that solution forward, then it will continue to be used.

Matt

Marilyn Mann said...

Therapyfirst is correct.
I put your blog on "NetworkedBlogs" on Facebook. It is one of my favorite blogs.

Marilyn Mann said...

Here's an update on Biederman:

http://www.nytimes.com/2008/12/31/health/policy/31psych.html

Stephany said...

CP--this blows my mind.

Anonymous said...

He's laughing all the way to the bank.