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Nov28
Scrutinizing Industry-Non-Profit Corporate Alliances, The ADA & Transparency
As readers of this blog are aware, I have previously focused on the relationships between healthcare non-profits and corporate sponsors, specifically pharmaceutical companies. In this post, I noted that the media and others are scrutinizing the activities of these organizations and looking for indications that they are being unduly influenced by their benefactors.  I suggested that one way to preserve the power of these alliances would be to proactively communicate about the details of these partnerships and how non-profits are maintaining independence from their drug company supporters.  

The American Diabetes Association (ADA) is the latest non-profit organization to have its motives and activities come under intense public scrutiny.  Last week, the New York Times published an extensive article looking at the ADA’s relationship with the food and pharmaceutical industries. 

Marc Santora, who wrote the article, had this to say about the ADA’s ties with food manufacturers:

“SnackWell’s Sugar-Free Lemon Creme cookies have nearly as many calories as some sugar-rich cookies. Yet, until recently the box featured an American Diabetes Association logo, advertising the cookie as a ‘proud sponsor’ of the charity’s efforts on behalf of the nation’s 21 million diabetics. But in the last year the A.D.A. began rethinking how it raises money from companies, especially from those whose primary business is selling foods and beverages that are high in calories, even if they have created some sugar-free items.  The group has allowed some food company deals to expire and has turned down millions of dollars in new sponsorships.”

In addition, Santora said this about the ADA’s relationship with drug firms: “Others remain concerned about the ADA’s relationships with pharmaceutical companies. Their presence is evident throughout the charity, from its annual convention, which is largely underwritten by drug makers, to its board meetings, where pharmaceutical executives have served on the volunteer committees that set policy.”  

Santora also examined how the ADA is developing medical guidelines governing the treatment of those with “pre-diabetes,” noting that people have criticized the non-profit for favoring drug therapy over lifestyle modifications like diet and exercise.  Last month, the ADA convened a panel of medical experts to look at the evidence for managing this condition with medication.  Currently, most guidelines suggest that these patients be counseled to lose weight, stop smoking and change their diets.
 
GlaxoSmithKline has a drug under Food and Drug Administration review for the management of pre-diabetes and the ADA’s recommendation could influence the agency’s decision to approve the drug.  Six of the seven members of the ADA panel have consulted for or conducted research funded by drug companies (see the Times’ graphic below).     

 

How The ADA Responded To The Times’ Questions

The major difference I noticed between the ADA’s response to questions about its ties to corporate sponsors and other non-profits is the level of access it gave to the Times.  Specifically, the ADA:

- Provided a copy of its guidelines governing its relationships with corporate sponsors to the Times.

- In the case of the ADA pre-diabetes guidelines, the non-profit provided details on the panel’s ties to the drug industry

- Candidly answered tough questions about the independence of its activities

Although the ADA addressed concerns about its fundraising, it understands that some people will never feel that the non-profit is unbiased.  Richard Kahn, MD, the ADA’s chief science officer, told the Times that it is difficult to balance the need to help people with diabetes and the reality that these activities have to be funded – often by drug firms.  He said that “there will always be [those] who think we are biased.” 

Roy Poses, MD, who contributes to the blog Health Care Renewal had this to say about the ADA’s financial backers:  “It may be very hard to prove such relationships have caused not-for-profit organizations like the ADA to do ‘something wrong,’ especially if one demands a scientific level of proof of causation.  On the other hand, a not-for-profit that gets a large amount of money from, say, the pharmaceutical industry might be hesitant to be critical of the industry or its products, or prone to give the industry the benefit of a doubt.  But even such relatively subtle biases could put the industrial benefactor's interests ahead of the not-for-profit organization's own mission.  Large, stable funding streams from commercial firms may be tempting, but not-for-profit leaders must ask themselves if they are worth the doubts they ought to raise.”

How The ADA Can Become Even More Transparent

Clearly, people will continue to ask questions about the ADA’s corporate backing and whether the organization is truly independent.  Yet, the fact remains that it is difficult to raise money for diabetes education and advocacy and non-profits like ADA will have to go to corporate sponsors for support if they are going to be able to fulfill their missions. 

I think that scrutiny of non-profit-industry partnerships will only intensify.  The ADA is already doing a wonderful job providing information about its activities.
Yet, I think the ADA can do even more.  Specifically:
 
- Right now, basic information about the ADA’s policies governing its relationship with corporate sponsors is not available on its Website.  I think that the ADA should prominently display this information on the site so that media and others can easily peruse and better understand its guidelines.

- The ADA might want to consider developing a FAQ document for media and others featuring answers to key questions about:

• Why it seeks (and needs) corporate support – especially from drug firms

• How it maintains its independence from corporate sponsors

• How it develops its medical guidelines and decides whether to endorse a product

• Basic information on its financial disclosure policies and how it manages perceived or actual conflicts of interest

I think that taking these basic steps will help the ADA better address criticism of its policies.  More importantly, proactive communication will help it preserve its reputation and increase its influence as it struggles to fight the worsening diabetes epidemic. 
 


2 Comments/Trackbacks




For example, some drug firms are taking steps to ensure that their marketing departments are not involved in providing unrestricted educational grants to third parties working in areas they have a financial interest in. Certain medical non-profits have developed very elaborate systems to ensure that pharma-sponsored projects are truly independent. However, the public and media are largely unaware of these efforts.

For example, some drug firms are taking steps to ensure that their marketing departments are not involved in providing unrestricted educational grants to third parties working in areas they have a financial interest in. Certain medical non-profits have developed very elaborate systems to ensure that pharma-sponsored projects are truly independent. However, the public and media are largely unaware of these efforts.

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