Anderson Timothy S, Good Chester B, Gellad Walid F
Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System; VA Center for Medication Safety, Department of Veterans Affairs; University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
BMJ. 2015 Sep 29;351:h4826. doi: 10.1136/bmj.h4826.
To identify the prevalence, characteristics, and compensation of members of the boards of directors of healthcare industry companies who hold academic appointments as leaders, professors, or trustees.
Cross sectional study.
US healthcare companies publicly traded on the NASDAQ or New York Stock Exchange in 2013.
3434 directors of pharmaceutical, biotechnology, medical equipment and supply, and healthcare provider companies.
Prevalence, annual compensation, and beneficial stock ownership of directors with affiliations as leaders, professors, or trustees of academic medical and research institutions.
446 healthcare companies met the study search criteria, of which 442 (99%) had publicly accessible disclosures on boards of directors. 180 companies (41%) had one or more academically affiliated directors. Directors were affiliated with 85 geographically diverse non-profit academic institutions, including 19 of the top 20 National Institute of Health funded medical schools and all of the 17 US News honor roll hospitals. Overall, these 279 academically affiliated directors included 73 leaders, 121 professors, and 85 trustees. Leaders included 17 chief executive officers and 11 vice presidents or executive officers of health systems and hospitals; 15 university presidents, provosts, and chancellors; and eight medical school deans or presidents. The total annual compensation to academically affiliated directors for their services to companies was $54,995,786 (£35,836,000; €49,185,900) (median individual compensation $193,000) and directors beneficially owned 59,831,477 shares of company stock (median 50,699 shares).
A substantial number and diversity of academic leaders, professors, and trustees hold directorships at US healthcare companies, with compensation often approaching or surpassing common academic clinical salaries. Dual obligations to for profit company shareholders and non-profit clinical and educational institutions pose considerable personal, financial, and institutional conflicts of interest beyond that of simple consulting relationships. These conflicts have not been fully addressed by professional societies or academic institutions and deserve additional review, regulation, and, in some cases, prohibition when conflicts cannot be reconciled.
确定担任领导、教授或受托人等学术职务的医疗行业公司董事会成员的比例、特征及薪酬情况。
横断面研究。
2013年在美国纳斯达克或纽约证券交易所公开上市的医疗公司。
制药、生物技术、医疗设备与供应以及医疗服务提供商公司的3434名董事。
担任学术医疗和研究机构领导、教授或受托人的董事的比例、年度薪酬及实益股票所有权。
446家医疗公司符合研究搜索标准,其中442家(99%)在董事会信息披露方面可公开获取。180家公司(41%)有一名或多名学术关联董事。这些董事与85家地理位置各异的非营利性学术机构有关联,包括国立卫生研究院资助排名前20的医学院中的19家以及美国新闻荣誉榜上所有17家医院。总体而言,这279名学术关联董事包括73名领导、121名教授和85名受托人。领导包括17名首席执行官以及11名卫生系统和医院的副总裁或执行官;15名大学校长、教务长和校长;以及8名医学院院长或校长。学术关联董事为公司服务的年度总薪酬为54,995,786美元(35,836,000英镑;49,185,900欧元)(个人薪酬中位数为193,000美元),董事实益拥有公司股票59,831,477股(中位数为50,699股)。
大量不同类型的学术领袖、教授和受托人在美国医疗公司担任董事,其薪酬往往接近或超过普通学术临床薪资。对营利性公司股东以及非营利性临床和教育机构的双重义务带来了超出简单咨询关系的重大个人、财务和机构利益冲突。这些冲突尚未得到专业协会或学术机构的充分解决,值得进一步审查、监管,在某些情况下,当冲突无法调和时应予以禁止。