Tuesday, July 27, 2010

Still Awaiting an Academic Physician to Suffer Consequences for Ghostwriting...

A plaint that regular readers of this blog have now heard several times: when is an academic physician going to suffer any bad consequences as a result of being exposed as having been the putative author of a ghostwritten article? When is one of our great academic medical centers, that huff and puff about how unethical ghostwriting is, going to prove it actually means business?

Just maybe we are a step closer.

A story was unfolding right in my own Texas back yard, which i was unaware of till tipped off by the redoubtable duo of Jonathan Leo and Jeffrey Lacasse, who have continued their anti-ghostwriting crusade in the Chronicle of Higher Education:

Not much new ground was covered in that article, that we have not already looked at previously:

However, they mentioned in passing that on July 12, Dr. Steven M. Haffner was accused in a letter from the U.S. Senate Finance Committee (read: Sen. Charles Grassley, R-IA) of having allowed his name to be placed on a ghostwritten article at the behest of GlaxoSmithKline, in that instance about Paxil. According to Sen. Grassley's folks, Haffner was a part of the CASPPER program revealed in internal GSK documents released by litigation, the program that won the award for "cute name" after it was edged out in the "professional ethics" category:

Hmm. Steven Haffner--where have we heard that name before? Sonofagun--that was the same guy who leaked the Nissen-Avandia research manuscript to GSK, in violation of the New England Journal's editorial policies (and all professional ethics):

Putting all that together led in turn to a recent article in The Daily Texan:

--and Ed Silverman at the Pharmalot blog:

--and finally an article by Paul Basken in Chronicle of Higher Education, July 16 (subscription required). Interestingly, neither the Chronicle nor the Daily Texan connected the dots; each reported the ghostwriting claim but not the NEJM leak.

What can we learn from all of this? The following seems to be the overall chronology based on what's been made public:
  • 2007: Dr. Haffner is on the faculty at University of Texas-San Antonio medical center. If you Google him you'll see right off the list of drug companies for whom he's a paid speaker and consultant. Being a GSK paid consultant, one day after being sent the manuscript of Nissen's paper on Avandia by the NEJM, he faxed a copy of the "confidential" manuscript to his pals at GSK.
  • 2008: Brian Vastag writes about the Haffner case for Nature (see: http://brodyhooked.blogspot.com/2010/04/should-drug-companies-censor-medical.html). Haffner tells Vastag he's really sorry for the slip-up; he was not feeling well that day and he made a bad decision.
  • 2008-2010: There is some muffled noise about both NEJM and UT-San Antonio investigating Dr. Haffner for this breach of editorial ethics. If there is any outcome, nobody says anything.
  • 2009: Dr. Haffner "retires" from UT-San Antonio. Possibly this has something to do with the above investigation? If so nothing is said.
  • 2009: Baylor College of Medicine in Houston hires Dr. Haffner as a part-time assistant professor. A Baylor spokesperson, in the context of the more recent flap, says that Baylor knew about the NEJM leak matter when they hired him and accordingly, hired him only part-time and only for limited activities related to his special expertise in clinical epidemiology of cardiac risks. Here we have some evidence of real consequences, even if people are not saying why. At San Antonio, Haffner had apparently held the rank of (full) professor, having been on their faculty since 1981. To be hired on by Baylor at the rank of assistant professor would seem like a pretty severe slap in the face.
  • July 2010: The Grassley subcommittee accuses Haffner of ghostwriting, and Baylor says it will investigate. (GSK, as you'd expect, claims that Haffner "contributed substantially" to the article he was said to have ghostwritten and so no ghostwriting occurred.)

So there is at least a chance that up to this point, Dr. Haffner has actually suffered some significant consequences; and there's a fair chance he stands to suffer more. In which case he'd be first case I know of that we can report thusly.

A personal disclaimer: some might imagine that I get my jollies from berating and outing my fellow academic physicians, not to mention those who are fellow members of the U-Texas System faculty. The fact is that any such naming of names is extremely distasteful and I wish I could see my way clear to avoiding this aspect of the whole mess. Why can I not see my way clear? Because if the root problem is that people engage in these unethical actions but nevertheless advance in their climb up the academic ladder; and in academe, one's good reputation is the main coin of the realm; then if you are not willing to name names, you are unfortunately perpetuating the very problem you seek to ameliorate. I heartily wish it were otherwise.


stata said...


You may have missed haffner's greatest work on behalf of his industry benefactors" his leadership in unleashing ATP-III and its aggressive rx of dyslipidemias. He did a lot of cme work advocating beyond the guidelines in addition.

Anonymous said...

Following up from stata:
Here is a link from a BNET article about whistleblower Jesse Polansky indicating that "S. Haffner" was both a member of NLEP (Pfizer's fig leaf CME) and NCEP. Is this our man?


Anonymous said...

Time magazine,Aug 23, 2010, has written about Dr. Haffner's work for GSK on behalf of Avandia and the shameful way the FDA and GSK covered up the risks associated with taking Avandia, just in case you missed it. How corrupt the whole drug approval system it.