Painkiller panel drops experts linked to pharma industry

Doctors dropped from panel looking at painkillers

A University of Maryland professor removed from a panel of experts advising the Food and Drug Administration on prescription painkillers said Friday she was surprised by the decision and believes she got caught up in politics.

Dr. Mary Lynn McPherson, who teaches in the School of Pharmacy and has a specialty in hospice and end-of-life care, was one of four doctors removed this week from the panel organized by the National Academies of Sciences, Engineering, and Medicine. The academies advise the FDA on medical issues.

The academies confirmed that the doctors had been dropped, but a spokeswoman said the group does not disclose reasons for not moving forward with a nomination to the panel. The decision, announced during the panel's first-ever meeting Wednesday, came after a U.S. senator from Oregon wrote a letter July 1 to the president of the National Academy of Medicine complaining that some panelists received funding from drugmakers or served in professional societies that received such funding.

The letter from Democratic Sen. Ron Wyden said McPherson received grants and funding for medical residents worth at least $300,000. The grants were sponsored or paid for by opioid drug makers dating back at least two decades, he wrote. Three residencies she ran between 1997 and 2004 were funded by Purdue Pharma, while Purdue Frederick funded three others. The companies gave a total of $253,500, according to the letter. And in 2010, McPherson received a $50,000 grant from King Pharmaceuticals.

She is also chairwoman of the board of directors of the American Society of Pain Educators, which Wyden said is sponsored in part by opioid manufacturers.

"I feel like a foot soldier caught up in a political maelstrom," McPherson said.

The removal of McPherson and the others comes amid increasing questions about how doctors are influenced by payments from the pharmaceutical and medical device industries. Nationwide, about 66 percent of hospital-affiliated doctors took some payment from such companies, according to an analysis of data from the Centers for Medicaid and Medicare Services by ProPublica, a nonprofit news organization.

McPherson said that her work has never been compromised by payments from drug companies and that the residency and education funding was used for legitimate purposes.

"The funding went to the university and salaries for residents," she said. "It didn't go to me. And these grants were unrestricted. They had no choice in who got the money and what it was used for. It was completely hands-off."

The dean of Maryland's School of Pharmacy also criticized the decision to remove the McPherson in a statement.

"Ultimately, it is patients who will be most affected by [the] decision to un-invite Dr. McPherson from participating on its committee focused on strategies to address pain management and prescription drug abuse," said Dean Natalie D. Eddington. "Her expertise as a world-renowned educator and practitioner would have been invaluable in formulating new strategies for dealing with the opioid addiction crisis facing the United States. With years of education and training focused on medications and their effect on the body, pharmacy practitioners like Dr. McPherson play a unique and valuable role in establishing guidelines and best practices for the treatment of pain and drug abuse."

Wyden was not available for comment beyond the letter, his spokesman said.

The FDA requested a report on the use of opioid painkillers after coming under fire for not doing enough to reduce fatal overdoses tied to the drugs , which have risen for the past 15 years. Federal advisers are supposed to be vetted for financial ties that can influence their judgment.

Drs. Gavin Bart, Howard Gutstein and Gregory Terman were also removed from the panel. Gutstein could not be reached for comment.

Terman, professor and director of pain medicine research at the University of Washington, said he was dismissed Tuesday afternoon by phone. He said he was told the decision was made because his nonprofit group, the American Pain Society, receives funding from drugmakers.

In his letter, Wyden noted that the society has a "corporate council" of pharmaceutical manufacturers — including Purdue Pharma, Pfizer and Teva Pharmaceuticals — that contributed at least $132,500 to the group. Terman has served on the group's board of directors since 1998, the letter said.

Terman said he was "extensively screened" by the National Academies for conflicts and that it was widely known that he headed the American Pain Society. The academies had also worried he had done too much work for the FDA, he said.

It is not unusual for professional groups to get funding from drugmakers through many avenues, including booth fees at conventions and grants, Terman said. The funding does not influence decisions, and the group's primary priority is science, he said.

"I have gone out of my way to avoid conflicts over the years," Terman said.

PhRMA, the Pharmaceutical Research and Manufacturers of America, declined to comment on the dismissals and its funding of doctor and professional society programs.

Wyden's letter also criticized the National Academy of Medicine for not disclosing all of the panelists' potential conflicts.

Bart is a regional director for the American Society of Addiction Medicine, which he said takes money from pharmaceutical and other companies. He said the group does not receive money from companies that make drugs that are addictive.

"Given that we live in a really highly politicized environment and there is concern about potential biases and influence, the National Academy is trying to be incredibly cautious," said Bart, director of the division of addiction medicine at Hennepin County (Minn.) Medical Center and associate professor of medicine at the University of Minnesota.

Wyden noted in his letter that there were potentially other panel members with financial conflicts of interest.

"My staff has been unable to thoroughly examine all of the members given the limited time available to review the provisional committee members," he wrote.

Wyden, the highest-ranking Democrat on the Senate Finance Committee, has been raising similar concerns for months about conflicts of interest on a pain panel organized by the National Institutes of Health. Last week he asked the NIH director to turn over documents on how those experts are vetted.

He also introduced a bill earlier this year aimed at protecting seniors from rising drug costs by capping Medicare enrollees' out-of-pocket drug costs at around $7,500.

The Associated Press contributed to this article.

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