With Industry Alliances for Medical Advances, Organizations Face More Elaborate Conflicts

A new chapter was written on the management of conflicts at Moffitt Cancer Center when a pharmaceutical company licensed technology developed by CEO Alan List, M.D., who is also a researcher and practicing physician. The deal meant big dollars for the CEO personally and a considerable investment in clinical trials at Moffitt using the new technology, but it presented all kinds of challenges for the Tampa, Florida, institution. List, who would normally negotiate a transaction of this scale, had to stay out of it, and so did the people who would have taken over because they report to him.

“We call this an institutional conflict of interest because he was the CEO and because of the significance of the deal with Moffitt,” said Donnetta Horseman, chief compliance officer at Moffitt. “We had to firewall him completely from this entire deal.”

The pharma company touches so many things that required oversight. Moffitt’s foundation accepts unrestricted grants from the drug manufacturer and they co-sponsor education events. Multiple research projects were underway at Moffitt that are funded by the pharmaceutical company, and Moffitt purchases a lot of its medications for use with patients. And there’s the potential for a clinical conflict if the CEO prescribes drugs made by this company when there are cheaper or more efficient alternatives.

“Every way you can imagine there could be a conflict, that conflict existed,” she said at the Health Care Compliance Association’s Compliance Institute April 16 and in an interview.

Although managing the conflicts “made my head hurt,” Horseman said, it was time to establish the necessary processes and procedures. “We are on the forefront of developing vaccines and technology to treat and try to cure cancer, and the only way to do that is through industry partnerships and alliances,” she said. “We have to figure out a way to get controls in place and manage institutional conflicts and reputational risks. Partnering to help us develop new technologies is how we will accomplish our mission and vision.” Moffitt has since addressed similar conflicts because of its work with pharmaceutical, device and biotech companies. “It’s a delicate balancing act between maintaining relationships and having it not appear as if we are biased toward these particular companies,” she noted.

For starters, Moffitt has established an institutional conflict of interest policy and committee with representatives from various departments, including a “disinterested” board member from the corporate compliance committee, a member of the center’s Patient and Family Advisory Council and an external representative from an unaffiliated academic medical center. It has a separate charter and committee to review institutional and business-related conflicts.

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