To the Editor:
I read with great interest and appreciation the letter from Dr. Irwin Nash in the March/April 2007 issue of The Hematologist. The issue he described was one of the major reasons for ASH starting its Development Task Force, which I had the privilege to chair from 2003 to 2005. The idea was to try to get away from the Society's dependence on the drug and instrument companies, which have greatly enriched the Society's treasury.
I was especially pleased to have initiated the Henry and Lillian Stratton endowment and the Stratton-Jaffé Scholar Award programs, which have served to support the independent funding of training and research programs and that led to the Clinical Research Training Institute.
I hope, therefore, that the Society's members, officers, and staff will continue their efforts in this direction.
Sincerely yours,
Ernst R. Jaffé, MD, 1983 ASH President
To the Editor:
The issue raised by Dr. Nash is serious. But in his passion to identify and correct the abuses, which are real, he uses what I’ll call a Rovian approach. That is the use of incomplete material to damn with a broad brush.
I was a speaker at the anemia education session, and I did record a consultation for Amgen on my disclosures. Actually, I did a single consultation for a company called Tularik that was testing an agent (for a non-hematologic condition) which produced an interesting form of anemia in animal models. Amgen bought Tularik, so I listed both. So much for my role as a consultant for erythropoeitic materials and companies.
However, I was ASH president in 2004, and during our regularly scheduled meetings with the NIH we learned from members of the National Institute on Aging (NIA) about the forthcoming NHANES 3 study that showed an unanticipated and severe impact of anemia in the elderly. Struck by the seriousness of the clinical condition and the lack of hard data, we officers worked with ASH members and staff to run an ASH/NIA-sponsored agenda-setting meeting on anemia of the aged. Financial support for this conference from the relevant companies was neither requested nor accepted; furthermore, the companies were explicitly excluded from attending the conference.
That conference was successful in identifying an agenda, based on which the NIA established an RFA. More than 20 proposals were submitted, and several were identified for funding, pending the passing of a Congressional budget. Certainly, we all hope that the outcome will be good basic and clinical research, which in turn will lead to better care for our patients. That is, of course, what ASH is all about. Consistent with that goal, the ASH Committee on Practice sponsored the education session on anemia of the elderly. Carefully collected feedback indicated that ASH members felt that the education session made an impact on their knowledge and practice.
Stanley L. Schrier, MD, 2004 ASH President, Stanford University School of Medicine
To the Editor:
I read with disappointment the letter to The Hematologist by our colleague Dr. Nash concerning the topic of corporate support and scientific integrity. In it, he appropriately calls attention to the issue of the potential for compromise of clinical research in pursuit of corporate profit. Unfortunately, he chooses to use the 2005 ASH Committee on Practice educational symposium on anemia of the elderly as the poster child for such abuse. Specifically Dr. Nash writes (and I quote exactly): “To see the effect [of corporate influence] on societies such as ASH, one could look at the symposium sensationally entitled ‘Anemia in the Elderly: A Public Health Care Crisis in Hematology.’ Could this emphasis on the issue of mild anemia have anything to do with the fact that all of the speakers were consultants for companies selling erythropoietin?”
As chairman of this session, and on behalf of the speakers and the Committee of Practice, the “facts” surrounding this session are as follows and not as Dr. Nash suggests:
This topic was chosen in support of a joint ASH / NIA consensus panel on anemia in the elderly that resulted in a joint research agenda /funding plan. Corporate participation was specifically avoided and there was no consultation with private companies concerning choice of topic.
Once the topic became known, we were offered a) unrestricted educational funds, b) data availability, and c) logistical support from commercial concerns. All were turned down.
I am not a consultant for a company that sells erythropoietin, nor have I ever been one.
Although the title was deliberately worded to be provocative, this was done to call attention to a significant, but poorly recognized health care issue that affects millions of Americans, increases mortality, and contributes in a major way to cardiovascular, renal, neuropsychiatric, and orthopedic morbidity. Given the gentrification of American society, anemia in the elderly represents a major health concern.
In short, corporate interests had no role whatsoever in the construct of this symposium. To imply differently does a disservice to the participants, the Committee on Practice, and the ASH membership.
Vincent J. Picozzi, MD, MMM, Chairman, ASH Subcommittee on Quality, Chairman, ASH Anemia in the Elderly Symposium, Virginia Mason Clinic
