I was looking for a group project for a new investigative reporting class for undergraduates that I would teach in spring 2011. I had already begun looking at the pharmaceutical industry's influence on clinical trials when ProPublica published its "Dollars for Docs" database.
Thanks to a series of court cases around the nation, a handful of drug companies were being forced to reveal payments they were making to physicians. ProPublica collected the drug company's publications—which were hard to find and even harder to extract data from—and put them in an easy-to-search database. It was meant not only to be a consumer resource (you can look up your doctors to see if they're on the take) but also to be a resource for investigative journalists looking into physicians' practices.
I realized that the database could be used to find direct payments from drug companies to scientists; as most clinical researchers are physicians, payments to researchers from certain big pharmaceutical manufacturers should be listed in the database.
In my journalism class at New York University we decided to use the database in two ways: First, we would look for payees on the list who happened to be National Institutes of Health advisory committee members. This would give us a little insight into money flowing to decision-makers at NIH. Secondly, we would join a small section of the database (payees in New York State; the whole database was too much for us to handle) with a publicly available database of NIH grantees. This would give a sense of how much money was flowing to individuals who were also taking government money to perform biomedical research.
My students—including Hoon Bae, Randy Kreider, Allan Kustanovich, Veronika LaRocque, and Farzana Zaman—did the heavy lifting of joining and cleaning up the databases.
People on these lists haven't necessarily done anything wrong. Many of these payments don't pose conflicts of interest. For instance, if someone takes money from a company yet doesn't do research related to that company's interests, then it might not be a problem. Also, if people are open and up front about whom they're taking money from—if they're telling their institutions or NIH about their consulting arrangements—they've done everything that they're obliged to do. But an essential job of watchdog journalism is to make sure that everybody's playing by the rules.
When looking through the list of NIH grantees, my eye was drawn almost immediately to Felicia Cosman and Robert Lindsay. Here were two researchers taking enough money from Eli Lilly to put them near the top of the list and who were working at the same institution, Helen Hayes Hospital, and publishing papers together. A quick look at their NIH grants showed that they were doing research on teriparatide, which is marketed by Lilly. Here was the appearance of a possible conflict of interest.
When applying for an NIH grant, an institution is required by federal regulations to ask investigators about financial entanglements—and when a conflict is identified, the institution had to reduce, manage or eliminate the conflict. (The wording of the regulations changed slightly as the investigation was underway.) I set out to find whether the law was being followed as required.