Sen. Wyden 'Hypocritical' About Healthcare Funding

By Pat Anson, Editor

Sen. Ron Wyden, who has raised serious allegations of bias and conflict of interest on federal health panels, has accepted nearly $2.7 million in campaign donations from the healthcare and insurance industries that he helps regulate, according to a review of campaign donations by Pain News Network.

Wyden accepted $2,060,004 from donors affiliated with pharmaceutical companies, hospitals, HMO’s, and healthcare professionals from 2011 to 2016, along with $636,861 from the insurance industry, according to OpenSecrets.org, which keeps a tabulation of campaign donations.

Some of Wyden's biggest donors were Blue Cross/Blue Shield, MetLife, Prudential and the American Health Care Association, which represents thousands of nursing homes.

The Oregon Democrat is the senior ranking minority member of the Senate Finance Committee, which has broad jurisdiction over tax and financial issues effecting healthcare and insurance, as well as Medicare, Medicaid and Obamacare.

“Senator Wyden himself is funded in part, by insurance companies and Pharma. Isn't it hypocritical for him to be critical of others with connections to Pharma? Why is there a different standard for him?” asks Lynn Webster, MD, former president of the American Academy of Pain Medicine.

“Senators shouldn’t be calling the kettle black. Senators should set an example for the rest of the country with regard to being free of conflicts of interest,” said patient advocate David Becker.

In recent months, Wyden has challenged the integrity of several pain experts and patient advocates on federal advisory committees, alleging they have a conflict of interest because they belong to organizations that accepted funding from drug makers.

He recently pressured the National Academy of Medicine to remove two doctors from a panel formed to advise the Food and Drug Administration about its policies on opioid pain medication.

SEN. RON WYDEN

In a lengthy letter to the president of the National Academy of Medicine, which appointed the panel, Wyden wrote that Dr. Gregory Terman and Dr. Mary Lynn McPherson both had “potential conflicts of interests and bias” because they belonged to organizations “with substantial ties to the pharmaceutical industry, specifically, opioid manufacturers.”   

Terman is the immediate past president of the American Pain Society (APS), which accepted over $350,000 in donations from drug makers in 2013, according to Wyden’s letter.  The senator listed Purdue Pharma, AstraZeneca, Endo, Pfizer and several other companies as APS donors.

Wyden said McPherson, a professor at the University of Maryland School of Pharmacy, also had significant ties to drug makers, and “received grants and residencies worth at least $300,000 that were sponsored – or paid directly – by opioid manufacturers.” 

Both Terman and McPherson were removed from the advisory panel within days of Wyden’s letter, along with two other doctors who specialize in pain management.

“It is incredibly hypocritical and disingenuous for anyone who accepts that much Pharma money to try to demonize the leadership of pain societies for accepting Pharma support, especially when there is no one else who will fund these societies,” said Michael Schatman, editor-in-chief of the Journal of Pain Research. “Greg Terman is ethically beyond reproach and exercised ethical leadership during his tenure as APS President.”

"Any implication that Dr. McPherson or her work has been compromised by association with pharmaceutical companies is deeply misguided," a University of Maryland spokesman said in a statement to the Associated Press.

"Serious Concerns" About Objectivity of Pain Panel

Wyden has raised similar concerns about conflicts of interest on the Interagency Pain Research Coordinating Committee (IPRCC) a federal panel that advises the government on pain care policies.

At a meeting last December, several members of the IPRCC were sharply critical of opioid guidelines then being developed by the Centers for Disease Control and Prevention, which discourage doctors from prescribing opioids for chronic pain. IPRCC members called the evidence used to justify the guidelines “ridiculous” and an “embarrassment to the government.”

INTERAGENCY PAIN RESEARCH COORDINATING COMMITTEE (iprcc)

That brought a rebuke from Wyden, who claimed in a February letter to Health and Human Services (HHS) Secretary Sylvia Burwell that he had “serious concerns about the objectivity of the panel’s members” and claimed they were trying to “weaken efforts” at CDC to rein in opioid prescribing. 

Wyden’s letter mentioned several members of the panel, including two patient advocates: Cindy Steinberg of the U.S. Pain Foundation and Penny Cowan of the American Chronic Pain Association. Both organizations are non-profits that accept donations from drug makers.

“I do not and have never been paid by a pharmaceutical company,” said Steinberg in an email to PNN. Steinberg, who suffers from chronic back pain, is National Policy Director for U.S. Pain Foundation and receives a small stipend of about $8,000 a year from the organization.

“I do this work despite my daily, debilitating chronic pain, often needing to lie flat in meetings to control the pain and lay across two plane seats to travel because I am passionate about improving pain care in this country,” said Steinberg.

Unhappy with the response to his first letter, Wyden followed up with another letter to Burwell last month, saying he had serious concerns about the agency’s “flawed conflict of interest policy.”

“Americans expect significant transparency when it comes to government policy making, particularly for an issue like the opioid crisis which is devastating communities in Oregon and across the country,” Wyden said in a statement. “I’m going to continue to demand accountability to ensure the manufacturers of these powerful prescription drugs aren’t having an undue influence on policies designed to reduce their usage.”

“Senator Wyden is misguided,” says Lynn Webster.  “I find irony in his attempt to purge members of the IRPCC that may have a different view than his just because they are associated with Pharma grants. It is anti-democratic.  We should invite different views not exclude them.”

Ironically, the CDC itself has been accused of bias for secretly impaneling a committee to help draft the guidelines and for holding a much maligned webinar for addiction treatment clinics, pharmacies, insurers and other special interest groups to provide input on the guidelines.

The CDC has a foundation that received over $157 million last year from donors, including Abbott Laboratories, Amgen, Medtronic, Johnson & Johnson, Merck, Quest Diagnostics and Pfizer, all companies which stand to benefit from the prescribing guidelines because they offer non-opioid treatments or tests.  The FDA also has a foundation that has accepted millions of dollars from many of the same companies.

“If Senator Wyden really wants to sanitize the panel, he will need to ask for removal of anyone who also has ties to insurance payers, including Medicare,” says Webster. “Since the FDA and CDC receive money from payers and Pharma, they should be stricken from the panel, too.  In fact since Medicare is a payer, anyone within HHS should not be allowed to be on the panel. They are too biased.”

Wyden’s one man campaign against bias recently led the FDA to revise its conflict of interest guidelines for advisory panels.  The proposed guidelines state that someone could be removed from a committee if there is any “appearance” of conflict, such as a non-profit accepting money from a company involved in a panel’s deliberations.

“This is an interest or relationship that could cause a reasonable person to question the member’s impartiality,” the guidelines state.

But activists say weeding out even the appearance of conflict could eliminate needed input from a medical or scientific expert, or a patient who would be directly impacted by FDA policy.  Virtually every medical school, professional association and non-profit involved in healthcare has accepted industry funding.

“The people who are most active in helping make change do have costs associated with their activities,” said Barby Ingle, President of the International Pain Foundation (iPain), a non-profit advocacy group that accepts industry funding. “Many people in the chronic pain community are low income and are not able to donate to charities to keep them going. Stopping grant funding would cut off the patient voice, which is already limited due to the physical condition of many chronic pain patients.”

“Eliminating people who have any association with Pharma is, in essence, stacking the deck. It creates a special interest group that’s empowered to influence prejudicial policy. This attempt to limit bias is creating bias,” says Webster.

Webster, who is vice president of scientific affairs at PRA Health Sciences, has himself been a frequent target of conflict of interest claims. According to a database maintained by Medicare, Webster received over $1.5 million in funding from healthcare companies last year for consulting fees, travel expenses, and research funding.

In 2012, Webster and several other prominent pain physicians were targeted in a Senate Finance Committee investigation that looked into allegations that drug makers bankrolled misleading marketing information about opioids and helped create the opioid abuse epidemic.  That investigation quietly ended without any hearings or an official report.

Four years later, critics are still demanding that documents related to the investigation be released. A Wyden spokesman recently suggested the investigation could be re-opened.

“Senator Wyden, now the ranking member of the minority, is deeply committed to curtailing the crisis of opioid addiction, and that includes holding accountable those who contributed to its rise in the first place,” said Wyden spokesman Taylor Harvey in STAT. “The documents related to the 2012 investigation are currently being reviewed by Democratic investigations staff. Senator Wyden intends to take official action related to this investigation.”

Wyden Campaign Donations Doubled

In his deep blue state of Oregon, Wyden is widely expected to be re-elected this fall. And if Republicans lose control of the Senate, he would emerge as the powerful new chair of the Senate Finance Committee.

That’s one reason why Wyden’s campaign donations have nearly doubled in recent years. The senator has received over $13 million from donors and political action committees, and has over $7.7 million in cash on hand, according to his campaign committee’s latest report.

Only four percent of the money raised so far has come from small, individual donors. Over $6 million has come from large individual contributions and another $3 million has come from PAC’s.

Donors affiliated with Blue Cross/Blue Shield ($124,500) are Wyden’s single biggest contributor, followed by Nike ($123,322), Intel ($73,807), the lobbying firm of Akin Gump ($68,155) and the physicians’ group DaVita HealthCare Partners ($64,750).

Other contributors to Wyden from the insurance and healthcare industries include MetLife ($47,507), Prudential ($37,500), nursing home operator Prestige Care ($36,000), Kindred Healthcare ($37,700) and Vibra Healthcare ($35,300). The latter two operate patient rehabilitation centers.

Wyden is by no means alone in raising substantial campaign donations. The current chairman of the Senate Finance Committee, Utah Republican Orrin Hatch, has raised over $14.5 million in campaign contributions,  according to OpenSecrets.org, and Hatch isn’t even up for re-election until 2018. Blue Cross/Blue Shield, Pfizer, Amgen and several other healthcare companies are some of Hatch’s biggest contributors

While there doesn’t appear to be anything illegal about these donations and they are a matter of public record, patient advocates like Barby Ingle say Wyden’s fundraising and potential conflicts of interest should get the same kind of scrutiny he demands of others.

“There have been times iPain has turned down funding from companies and private donors because there were strings attached to accepting the funding,” says Ingle. “I wonder now, has a legislator ever turned down donations because they were given with strings attached? I do believe it is a conflict of interest if a majority of operational funds for the nonprofit come from pharmaceutical companies, but the rule should apply to legislators as well.”

A request for comment on this story from Wyden’s office went unanswered.