Douglas Noordsy, Craig Donnelly, Robert Santulli and Jeffrey Fetter who serve as psychiatrists either at Dartmouth-Hitchcock Medical Center or New Hampshire Hospital received $35,500, $30,250, $9,300 and $6,300, respectively, for work with Eli Lilly during the first quarter of 2009. DMS professor Richard Rubin, the director of the Vermont Clinical Study Center in Burlington, Vt., received $15,000 from the company.
Faculty members are limited to accepting $30,000 or 10 percent of their salary in compensation, DHMC media coordinator Jason Aldous said in an interview with The Dartmouth, though he said that exceptions can be made on a case-by-case basis.
"We see no evidence that our policy has been broken," Aldous said, when asked about one of the doctors who had received over $30,000 from Eli Lilly.
Santulli and Fetter declined to comment when contacted by The Dartmouth. Noordsy, Donnelly and Rubin could not be reached for comment by press time.
Faculty must contact their department chair and the Hitchcock Foundation, which manages research funding and fellowships at DHMC, prior to entering in any sort of "professional relationship," Aldous said. The Hitchcock Foundation also oversees changes to professional service agreements that may occur over time, he said. DHMC conflict of interest policy also applies to DMS faculty members who practice or teach at the medical center.
Eli Lilly limits compensation for patient education, health care professional education and advising activities to $75,000 per doctor per year, according to its web site.
Donnelly and Santulli were compensated for health care professional education, which Eli Lilly defines on its web site as "programs intended to enhance a health care professional's knowledge and patient care expertise." During these programs, doctors present scripted information that is provided by Eli Lilly, according to Eli Lilly representative Carol Puls.
"Health care providers prefer to get information from their peers, who are experienced, credible sources of information," she said.
The presentations are created by individuals with "critical clinical expertise," Puls said, though she did not specify if researchers involved in drug development were involved.
"Presentations are put together with the experience and depth of knowledge of a lot of people, including our advisers, who are the best in their field," Puls said.
Representatives from Eli Lilly are also involved in the creation of the presentations, Puls said. The information presented must conform to U.S. Food and Drug Administration guidelines, but the doctors hired to give the presentations are not necessarily involved in developing the material.
DHMC's Code of Professional Conduct prohibits compensation exceeding fair market value, and prohibits any association between pharmaceutical compensation and patient prescriptions, Aldous said.
"The central issue is one of providing bona fide professional service versus simply accepting money or something of monetary value," Aldous said.
Puls said that Eli Lilly's new policy of posting payment information online has not discouraged academic professionals from working with the company. Less than 1 percent of the physicians invited to work with the company choose to decline the offer, she said.
"I do think some coverage has been somewhat negative, trying to get into the controversy around potential conflicts of interest," Puls said.
Other pharmaceutical companies, including Merck, are planning similar efforts to go public with their faculty compensation figures, Aldous said, pointing to a trend towards greater transparency of faculty-pharmaceutical relations.
"It is still very, very important to manage those relationships effectively and to put appropriate safeguards in place through a policy that is reasonable and based on a foundation of trust," Aldous said, emphasizing that he does not foresee any problems arising from the increased transparency.
In 2007, DHMC enacted a policy that prohibits faculty from accepting gifts or meals from drug and medical-device companies, according to Dartmouth Medicine Magazine.
Dartmouth College researchers are also subject to rules that regulate their involvement with pharmaceutical companies, vice provost for research Martin Wybourne said in an interview. Faculty frequently work with drug companies and are required to disclose their involvement to the College, Wybourne said. Dartmouth also has a policy, enacted in 2007, that prohibits drug company representatives from visiting campus.
"Issues around conflict of interest are something that we and our colleagues at the medical school have been actively looking at for some time and will continue to look at, on an ongoing basis," Aldous said.
