Bitter Pills: Harvard Medical School and Big Pharma
If there’s such a thing as an anti-Angell, it’s Harvard hematologist Tom Stossel, brother of libertarian journalist John Stossel. When Angell wrote an op-ed in the Globe several months ago, Stossel promptly penned a rebuttal in Forbes. When Stossel was invited to speak at a 2007 public panel on pharma influence issues, Angell blasted the choice, saying that to include him amounted to "standing the whole thing on its head." The two are "matter and antimatter," says one acquaintance. "Put them in the same room and the universe might explode."
In fact, Angell and Stossel have been in the same room at least once. At what should have been a fairly dry meeting of the American Society of Hematology in 2002, they gave dueling talks. Angell spoke in broad terms about the "dissolving" boundaries between academia and industry; the fact that medical meetings had become "a massive trade show…with free goodies." Stossel got more personal. "I don’t need to feel morally superior to drug companies," he said. "Let’s object to sanctimony." Today, in person, he’s even more barbed: When it comes to research credentials, he says, "I don’t even consider myself in the same universe as Marcia Angell."
Like Angell, Stossel is well aware that Harvard physicians pull in a lot of money from drug companies. Unlike Angell, he sees that as a good thing. Stossel traces improvement in Americans’ health directly to breakthroughs funded by the pharmaceutical industry. Limit doctors’ interactions with that industry, he argues, and you limit the power of the market to drive innovation.
Stossel also argues that the various controversies concerning Harvard and Big Pharma are overblown. The Pfizer rep with the cell phone wasn’t plotting a corporate takedown of the student protesters; he was taking photos of a public event out of personal interest. The professor who didn’t reveal his links to cholesterol drugs wasn’t technically doing anything wrong; Harvard only now requires that doctors disclose conflicts of interest in all public venues, including classrooms.
Stossel even refuses to condemn Biederman, the child psychiatrist, though he won’t quite defend him, either. "The second you show me solid evidence that he should have backed off on some conclusion and didn’t, he’s toast," says Stossel. "But I bet what [the ongoing investigation] will find is that he didn’t do anything wrong." Besides, he points out, having one bad apple among almost 10,000 faculty members is a risk worth taking. "We have to tolerate some bad behavior if we want progress," he says.
This past summer Stossel cofounded the Association of Clinical Researchers and Educators (ACRE), an advocacy group for doctor/drug company partnerships. It has been ruthlessly parodied—most notably as Academics Craving Reimbursement for Everything—but it has also attracted some followers, even among Harvard med students, some of whom say they’re uncomfortable with the protesters’ divisive stance. Angell’s acolytes are "a vocal minority," says Vijay Yanamadala, a med student who sides with Stossel. "We all agree on more than we disagree."