Many nonprofit academic leaders and professors serve on for-profit health-care company boards

The analysis, published in today's issue of The BMJ, found that academically affiliated board members were compensated an average of $193,000 in 2013 for their board memberships and often also held significant company stock.

"Academia should encourage collaboration with industry and these partnerships have the potential to advance science and improve health, but board membership is a step beyond consulting or collaborating," said senior author Walid Gellad, M.D., M.P.H., associate professor of medicine and co-director of the Center for Pharmaceutical Policy and Prescribing at Pitt, and physician in the U.S. Department of Veterans Affairs (VA) Pittsburgh Healthcare System. "Board members are part of the company's leadership, have substantial equity in the company and have a duty to shareholders, which can potentially lead to conflicts of interest with their academic duties."

Dr. Gellad, Timothy Anderson, M.D., chief medical resident in Pitt's Department of Internal Medicine, and Chester B. Good, M.D., M.P.H., of the University of Pittsburgh and VA Pittsburgh Healthcare System, analyzed the public disclosures of all publicly traded U.S. health care companies listed on the NASDAQ exchange and New York Stock Exchange in January 2014 that specialized in pharmaceuticals, biotechnology, medical equipment and providing health care services.

Of the 442 companies with publicly accessible disclosures on boards of directors, 180 -- or 41 percent -- had one or more academically affiliated directors in 2013. These individuals included professors, trustees, chief executive officers, vice presidents, presidents, provosts, chancellors and deans from 85 non-profit academic research and health care institutions.

The 279 academically affiliated board members received annual compensation totaling over $54 million and owned over 59 million shares of company stock.

The U.S. Physician Sunshine Act, which requires nearly all payments to physicians and academic medical centers be reported annually by pharmaceutical and medical device companies, does not require separate reporting of payments for serving as a company director.

"As our analysis shows, many academic leaders and professors in medicine may have significant industry relationships not captured by the Sunshine Act," said Dr. Anderson, lead author of the analysis. "Often when we talk about conflicts of interest in medicine, we are talking about physicians receiving pens and meals from sales representatives. The stakes are much higher for the board members in our study."

The team intentionally did not disclose the names of the academically affiliated board members in their analysis in an effort to highlight the issue, not the individuals.

"Our goal was not to pass judgement but to start an open discussion," said Dr. Anderson. "We do not expect a one-size-fits-all approach would work in managing these relationships, but we risk undermining the public's trust if these conflicts of interest are not addressed openly."

Dr. Gellad has previously received and reported consulting fees from IMS Health and grant funding from Express Scripts for work unrelated to The BMJ publication. Dr. Gellad was supported through VA Health Services Research & Development award CDA 09-207.