Big Pharma’s Revolving Door With Government Health Agencies
- by Carolyn Hendler, JD
- Published September 19, 2023
- Cultural Values
More than half of the staff at the U.S. Centers for Disease Control and Prevention (CDC) go to work for pharmaceutical giants when they leave the government, according to a new report by researchers at the University of Southern California and Harvard University. The report showed that eight percent of the CDC staff came from the pharmaceutical industry and 54 percent of the staff moved on to the pharmaceutical industry after they left the CDC during 2004-2020.1 2
Meanwhile, 15 percent of the staff at the U.S. Department of Health and Human Services (HHS) came directly from the private health care sector and 32 percent of those who leave HHS go work in private health care. At the Centers for Medicare & Medicaid Services (CMS), 53 percent of the staff take a job in the private health care sector when they leave CMS.3
The researchers said:
The sheer scale of the revolving door that we have identified … is troubling and merits further scrutiny. The risks posed to the functioning of and public trust in HHS warrants study into how these government-industry flows are affecting agency decision-making, especially in offices with the highest net exit rates.4
Conflict of Interest Laws Do Not Go Far Enough
The report concludes that current conflict of interest laws are not sufficient to prevent potential influence and corruption. The so-called “revolving door” laws prevent government employees from performing “representational” activities such as lobbying, communicating with or appearing before an officer or employee of their former agency in an attempt to take official action for only one year after their government employment ends.5 6
According to the researchers, the revolving door may fail to prevent private sector influence on government agencies as the laws are narrow in scope and, “do not cover much lobbying related to agency decision making, like regulations and drug authorizations—so they don’t necessarily deter that behavior.”7
A 2018 Analysis Revealed Same Revolving Door Between Government and Big Pharma
A 2018 Kaiser Health News (KHN) analysis of data provided by Legistorm, a website and research organization for government affairs professionals, raised concerns about the revolving door between government agencies and private pharmaceutical companies. The analysis showed that 340 former congressional workers made the jump to pharmaceutical companies while more than a dozen ex-pharmaceutical employees moved over to a government job.
According to the KHN report, many of the government workers who came from pharmaceutical industries kept their drug industry pensions and stock from their former drug company employer.8
Jack Friedly, Legistorm’s president and founder asked about the government employees,
Who do they really work for? Are they working for the person who is paying their bills at that moment or are they essentially working on behalf of the interests who have funded them in the past and may fund them in the future?9
In 2015, Marilyn Tavenner, chief administrator of Medicare from 2013 through 2015, began working as CEO of America’s Health insurance Plans, a national trade organization for insurance companies. In 2018, Alex Azar, former head of Eli Lilly from 2012 through 2017 was hired as the HHS secretary.10
In 2019, former U.S. Food and Drug Administration (FDA) commissioner Scott Gottlieb, MD joined the board of directors at Pfizer. In fact, nine out of the last 10 FDA commissioners went on to work for the pharmaceutical industry after leaving the government. With all but one leader of the government agency that approves drugs in this country heading straight to a private pharmaceutical company immediately after leaving office, questions about conflict of interest abound.11
Conflicts of Interest at the FDA
A 2016 BMJ study found that 15 out of 26 FDA staffers who conducted drug reviews in the hematology oncology field over a nine-year period left the government to work or consult for private biopharmaceutical companies. Another analysis by Science showed that 11 out of 16 FDA medical examiners, who played a role in approving 28 drugs, left the agency to work for or consult with pharmaceutical companies involved in the drugs they had regulated in their government agency position.
In 2010, FDA staff member Jeffrey Siegal, MD oversaw the approval of Genentech’s arthritis drug and within months, he left the FDA to work for Genentech’s parent company, Roche, as director of the division in charge of that same arthritis drug. Shortly thereafter, Siegal was in charge as Genentech sought further approval of the same drug for new conditions before some of his FDA colleagues.12
According to Vinay Prasad, MD, MPH, a hematologist-oncologist at Oregon Health & Science University in Portland and co-author of the BMJ study, there is a bias among FDA staffers when approving drugs.
Dr. Prasad explained:
When your No. 1, major employer after you leave your job is sitting across the table from you, you’re not going to be a hard-ass when you regulate. That’s just human nature.
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