[SSRI-Research] Scientists Decode Secret of Getting NIH Grants-WSJ

[Guest guest]

JustSayNo

Mon, 28 Jun 2004 21:37:42 -0400

[sSRI-Research] Scientists Decode Secret of Getting NIH Grants-WSJ

 

The Secret of Getting Grants: Marketing Helps University Win $350 Million a

Year, by Bernard Wysocki, a front page article in The Wall Street Journal,

provides insight into an iron triangle that controls medical research. This

triumvirate has tainted not only the grant approval process but the focus

and integrity of research, as greed and ambition have won over scientific

merit.

 

The article focuses in particular on the University of Pittsburgh (Pitts),

and the aggressive, manipulative marketing tactics employed by a master

grant getter, Dr. David Kupfer, head of the department of psychiatry, who

has succeeded in obtaining hundreds of millions in grants annually from the

National Institutes of Health and untold millions from the pharmaceutical

industry.

 

Inasmuch as psychiatry has made hardly any advances in the treatment of

mental illness--which is ostensibly the focus of psychiatric

research--Congress should be asking what was done with those funds?

 

That is not to say, that psychiatry has done nothing with the money. The WSJ

reports: " Pitt's strategy, since the university is building a $205 million

biomedical tower scheduled to open in 2005. The tower will have annual

operating costs of about $75 million. More than 80% of this is expected to

come from NIH grants. "

 

High profile academic psychiatrists, such as Dr. Kupfer (the center piece in

the article), have been enormously successful in garnering both government

grants and pharmaceutical company contracts. University-based psychiatrists,

whose influence at the National Institute of Mental Health is described in

the WSJ article, simultaneously collaborate closely with drug manufacturers.

Together they have made psychotropic drugs blockbuster profit earners: in

2003 antidepressant drug sales rose to $19.5 billion and

antipsychotic drug sales rose to $12.2 billion.

 

This marketing feat was accomplished by an iron triangle composed of

pharmaceutical company executives, university psychiatrists, and NIMH

psychiatrists who worked in unison to promote the newest, most expensive

psychotropic drugs--antidepressants of the SSRI class and so-called atypical

anti-psychotics--as first line treatment for anyone complaining about almost

any dissatisfaction. The drugs are widely and indiscriminately prescribed

even though they have failed to demonstrate safety or effectiveness in

controlled clinical trials conducted by a cadre of academic / company

investigators. The successful marketing of the drugs was accomplished by

concealing evidence from failed trials and evidence of severe adverse drug

effects--including increased risk of suicidal behavior which, in children is

double the risk.

 

The Wall Street Journal report concludes:

 

These days, with NIH funding on a plateau after the five-year doubling, Drs.

Levine and Kupfer are ratcheting up the pressure on scientists to keep up

the frenzy of grant applications. Dr. Kupfer says he wants the number of

psychiatry department proposals to double, from 165 last year, to take more

of the NIH money in a flat market. " We will increase our market share, " he

vows.

 

 

ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)

Promoting openness and full disclosure

http://www.ahrp.org

 

Contact: Vera Hassner Sharav

Tel: 212-595-8974

e-mail: veracare

 

~~~~~~~~~~~~~~~

THE WALL STREET JOURNAL

 

At Pitt, Scientists Decode The Secret of Getting Grants

 

By BERNARD WYSOCKI JR.

June 28, 2004; Page A1

 

PITTSBURGH -- For David Kupfer, getting grant money from the National

Institutes of Health isn't only about science. Marketing is also key to

success. So earlier this month, the head of the University of Pittsburgh's

psychiatry department used an NIH-sponsored conference in Phoenix for a bit

of self-promotion. Allotted five minutes to speak as co-chairman of a panel

on bipolar disorder, he filled the time with a PowerPoint presentation

pitching his own ideas on the subject -- which are central to a $4 million

grant proposal now pending at NIH. In the audience: prominent psychiatrists

who sit on the NIH review panel that will help decide whether Pitt gets the

money.

 

The maneuver is one of many that Dr. Kupfer, 63 years old, says he uses to

try to score hundreds of millions of dollars for Pitt in grants from Uncle

Sam. A consummate schmoozer, he chats up NIH officials about hot new areas

that might produce funding for his 240 faculty members and researchers. He

requires young Pitt scientists to attend boot camps on grant writing. And he

makes sure the scientists who win NIH money get onto the agency's review

committees to further penetrate the grant-giving system at NIH, in Bethesda,

Md. Researchers can get bonuses of as much as $50,000 a year based on how

much NIH money they bring to Pitt.

 

" We're called Bethesda North, " says Dr. Kupfer.

 

There's a lot of NIH money to be had. In the past five years, the budget of

NIH has doubled, to $28 billion. Some of that money goes to researchers in

Bethesda who are directly employed by NIH's 27 institutes, such as the

National Cancer Institute. But the lion's share -- about 80% -- gets

parceled out to other researchers across the U.S.

 

NIH isn't the only government agency whose largess is eagerly sought by

universities. In Atlanta, Emory University has used its proximity to the

federal Centers for Disease Control to win contracts for CDC-related

research. The University of Pennsylvania has created an Institute of

Strategic Threat Analysis and Response, a loose alliance of experts from 12

Penn graduate schools, to go after big federal grants from the Department of

Homeland Security and other sources of funds.

 

Few institutions, though, have made such a grab for market share in

government funding as the University of Pittsburgh and its affiliated

20-hospital medical center. A research also-ran 20 years ago, Pitt has

successfully gone after NIH funds in psychiatry, cancer research, genetics,

and other fields. The university has funneled revenue from its

organ-transplant program, a world leader since the 1980s, into recruiting

new faculty and expanding its research. Last year, thanks in part to the

newcomers, Pitt pulled in $350 million of NIH money. That made it the

eighth-biggest recipient, up from No. 12 just five years ago and ahead of

such eminent research universities as Yale, Duke and Columbia.

 

In a cheeky symbol of its emergence into the top tier, Pitt last September

recruited away the entire 20-person biosecurity think tank from Johns

Hopkins University, the No. 1 recipient of NIH funds. Pitt pledged to spend

$12 million getting the team established at spiffy offices in downtown

Baltimore. It hopes the biosecurity researchers will get government money,

especially homeland-security funds, not only for themselves but also for

colleagues in Pittsburgh.

 

" As long as the federal government is the major funder in the billions of

dollars, we want our colleagues to be in the Baltimore-Washington area ...

[and] quite frankly to be first in line to bring the funds back to

Pittsburgh, " said Jeffrey Romoff, president of the University of Pittsburgh

Medical Center and architect of the deal, speaking at a press conference. In

return for all this money, of course, the American public is supposed to get

progress in combating disease. The university's cutting-edge research

includes an effort to reverse the effects of stroke by surgically implanting

nerve cells. It has also developed a substance called Pittsburgh compound B

that enhances images taken of the brains of Alzheimer's-disease patients.

Still, research universities and NIH itself are under pressure from Congress

to show even greater results. Some legislators want NIH to devote itself

less to fundamental scientific inquiry and more to " translational " research

that can generate drugs, devices and other therapies. Among scientists,

there is fierce debate about how to make research more productive. Some

think NIH allows too much bottom-up research proposed by individual

scientists; others say it creates too many top-down megaprojects with grand

but elusive goals. Pitt plays both sides of the game, with big teams and

individual efforts, and its success is the envy of other universities.

" We're consciously headed in the same direction, " says Fred Sanfilippo,

senior vice president of health sciences at Ohio State University, which is

building a $150 million biomedical tower. The battle for grants is expected

to become more bare-knuckled because the NIH is no longer getting

double-digit budget increases each year -- a result of the federal budget

deficit and feelings in Congress that the institutes now receive enough

money. Already, there is resentment against Pitt, say some scientists.

Thomas Insel, director of the National Institute of Mental Health, says

people from competitor universities who sit on review panels sometimes say,

" God, those people already have so much going on; we need to spread the

wealth. " Michael Swift, a genetics specialist formerly at the University of

North Carolina and New York Medical College, is a critic of Pitt. " They're

teaching people how to work the system, " he says. " What does it have to do

with science or health? It has a lot to do with money. " Dr. Swift, 69, won

more than $10 million in NIH grants during his career but has had trouble

getting NIH funding in recent years. He is now retired from academia and

does research independently. By far the biggest winner in getting NIH

money -- and the template for the rest of Pitt -- is the university's

psychiatry department and its affiliated 276-bed Western Psychiatric

Institute and Clinic, which last year pulled in nearly $75 million in funds

from NIH, mostly from the National Institute of Mental Health. Dr. Kupfer, a

trim New York native, operates from the institute's Depression-era brick

tower with a salesman's optimism. He frequently calls branch chiefs at NIH's

various institutes and keeps in constant touch with Pitt researchers who

leave to take positions there, inviting them back for lectures. Of one

colleague who left for NIH, he says fondly, " He left but he never really

left. "

 

Within NIH's mental-health institute, Pitt has long occupied a spot on the

18-person national advisory council, which makes funding recommendations to

the director after an initial review by scientific committees made up of

experts in specific subfields. People now speak of the " Pittsburgh seat " on

the advisory council. Other universities have representatives on the

council, but nobody talks of a " Yale seat " or a " Cornell seat. "

The current occupant of the Pittsburgh seat is Charles Reynolds, a senior

Pitt faculty member. " It's extremely self-serving, " says Dr. Reynolds of his

position on the advisory council. He has used his seat, he says, to lobby

successfully to reinstate a branch of the mental-health institute devoted to

his specialty, the mental health of the elderly, although he plays no role

in approving his own grant proposals.

 

To make sure Pittsburgh stays ahead of the pack, Dr. Kupfer runs an

intensive " survival skills " course for young postdoctoral fellows in

psychiatry to train them in the fine points of applying for their first

grants, typically about $600,000 for five years. The biggest trick young

scientists need to learn, he says, is to focus their proposals more

narrowly. To Dr. Kupfer, it's almost like marketing or branding. " You need a

T-shirt, " he constantly exhorts his charges, by which he means a quick

phrase that tells the world what the research stands for.

 

These days, with NIH funding on a plateau after the five-year doubling, Drs.

Levine and Kupfer are ratcheting up the pressure on scientists to keep up

the frenzy of grant applications. Dr. Kupfer says he wants the number of

psychiatry department proposals to double, from 165 last year, to take more

of the NIH money in a flat market. " We will increase our market share, " he

vows.

 

As added incentive, Dr. Kupfer runs a bonus program that allows scientists

to get a payment equal to 10% of the size of a grant, up to $50,000 a year.

The program, once limited to the psychiatry program, has been expanded by

Dr. Levine to all of Pitt's health sciences departments.

 

Dr. Kupfer also thinks psychiatry can tap sources of funding beyond NIH's

mental-health institute by teaming up with scientists in other fields. A few

weeks ago, he spent an hour brainstorming with Tara O'Toole, the head of the

biosecurity team that Pitt lured from Johns Hopkins, on ways to join forces.

One idea: trying to get grant money, from the NIH or elsewhere, to study how

to avoid mass public hysteria in the event of a terrorist attack.

 

 

FAIR USE NOTICE: This may contain copyrighted (C ) material the use of which

has not always been specifically authorized by the copyright owner. Such

material is made available for educational purposes, to advance

understanding of human rights, democracy, scientific, moral, ethical, and

social justice issues, etc. It is believed that this constitutes a 'fair

use' of any such copyrighted material as provided for in Title 17 U.S.C.

section 107 of the US Copyright Law. This material is distributed without

profit.

 

SSRI-Research/