University of Toronto: Doing It Again?

The Prescription Project reports that Dr. Claire Bombardier has been named to a new rheumatology chair in the University of Toronto Faculty of Medicine, to be funded by a $1.5M grant from Pfizer: http://prescriptionproject.org/blog/?p=112.

Dr. Bombardier is well known to us critics of medicine-Pharma relationships as the principal author of the VIGOR study (New England Journal, 2000) that purported to show that rofecoxib (Vioxx) caused significantly fewer serious gastrointestinal bleeds than a standard anti-inflammatory medication for arthritis. So we might ask about this lovely marriage between Dr. B. and Toronto. The material for discussion is all documented carefully in HOOKED.

On Dr. B's side, we have the interesting fact that VIGOR actually contained within it much of the data needed to conclude that Vioxx caused more heart attacks than GI bleeds prevented--four years before Vioxx was finally taken off the market--even though the authors, apparently with the active complicity of the NEJM editors, did their best to conceal this inconvenient truth. Later NEJM tried to get off the hook by issuing an Expression of Concern (whatever that is) claiming that Dr. B. and her group had withheld from NEJM the reports of several heart attacks in the Vioxx arm of the trial. That apparently did happen, but NEJM did not follow its own proper internal procedures in making that charge. It remains the case that even without those extra heart attacks, Jim Wright of the Therapeutics Initiative, U. British Columbia, and John Abramson in his excellent book Overdosed America, were each able independently to calculate from the VIGOR data that Vioxx posed an excess risk of heart attacks.

On the Toronto side, we have the fact that the University has been implicated previously in not one but two scandals that involved taking money (or wanting to take money) from big drug firms. First there was the infamous case of Dr. Nancy Olivieri, who was severely mistreated by the Hospital for Sick Children when she got crosswise with the generic drug company Apotex over a drug for iron overload in thalassemia. (Apotex had made known its intention of donating multiple millions of dollars for a new research building at Toronto.) Next was the case of Dr. David Healy, who was hired by Toronto to head a psychiatric research institute, then unceremoneously de-hired when he dissed Prozac, which was manufactured by Eli Lilly, one of the major donors to the institute.

Subsequently, officials of the University of Toronto published a paper defending the institution's reputation and insisting that new, strict guidelines had been put in place since the Olivieri incident in particular; and they were backed up by no less a source than Robert Steinbrook, who frequently contributes commentaries critical of industry conflict of interest to NEJM. (For citations see HOOKED, p. 336, note 23.) The new professorship and the recruitment of Dr. Bombardier does not suggets that they have done much to turn over a new leaf. I once asked a colleague who works at a different Canadian university for his take on the Olivieri matter; and his reply was that in his circles, Toronto is generally regarded as the "whore of the Canadian universities."