Editor’s Note: This is the second of a three-part series on the National Lipid Association. The first part focused on the NLA’s publication of a series of papers offering expert guidance on familial hypercholesterolemia, and raised questions about the role of industry in the documents. This second part explores additional questions about the NLA’s relationships with industry and other issues concerning the organization’s management. In the third part the NLA answers questions sent to them about some of the issues raised in this series.
Industry support for NLA runs well beyond the FH guidelines. It is almost certainly not a coincidence that the attention newly focused on FH comes at the same time as several new drugs for FH are nearing regulatory approval. Here’s the cover of a brochure recently published by the NLA:
And here’s the back cover (note that Genzyme, in conjunction with ISIS pharmaceuticals, is developing the drug mipomersen specifically for an FH indication):
FH, however, is only a small part of the NLA’s ties to industry. The NLA offers a multitude of CME programs, nearly all of which are commerically supported by the pharmaceutical industry. Often the content of the programs are closely tied to the interests of the sponsor. For instance, the program on “Lipid-Altering Drug Pharmacology and Safety” is supported by Abbott, Merck/Schering-Plough, and Reliant, all of whom manufacture popular lipid drugs.
Furthermore, these programs are designed to help physicians and other healthcare professionals obtain enough credits to become “certified” as a lipid specialist, and it is nearly impossible to obtain this certification without utilizing these CME programs and other commercially sponsored educational programs, all designed by the same NLA leaders, nearly all of whom have extensive industry ties, including ties to the sponsoring companies.
Recently, ProPublica published a series of articles about the close financial ties between industry and the Heart Rhythm Society and the Society for Cardiac Angiography and Interventions (SCAI). The relationship of the NLA with industry appears to be at least as deep as the the relationship of these organizations with industry. However, the NLA does not provide a detailed account of its revenue from industry, so it is impossible to say with certainty precisely how reliant it is upon industry support.
Like the HRS and other medical societies, the annual meeting of the NLA provides a ripe opportunity for selling access to its membership. An NLA document describes the Marketing & Sponsorship Opportunities available to industry, including booths, social receptions, “Innovation Lab Workshops,” and of course portfolio bags, hotel key cards, name badge cords, and other tchotchkes. The motto on the cover of the brochure tells the whole story: “connect • collaborate • contribute”:
Finally, I want to raise one more question about the NLA. I’m far from being an expert on the financial workings of nonprofits, but a cursory examination of the available financial information about the NLA raises additional questions about the management of the organization. Besides its lack of disclosure about industry support, the NLA also does not disclose what it pays its officers or other officials. But at the end of the 2010 financial statement posted on its website I found this (click to enlarge):
If I read this correctly, companies owned by the executive director received about $1.3 million last year from the NLA, out of total NLA revenues of $3.6 million. At the very least, this relationship needs to be carefully scrutinized.
But this isn’t all. The executive director, Christopher Seymour, and his company, Compass Management and Consulting, also have similar ties with, and receive additional fees from, other NLA-related entities, including the NLA Foundation, the American Board of Clinical Lipidology, and the Accreditation Council for Clinical Lipidology. The last two organizations are the certifying organizations for the NLA’s programs. There is a tremendous amount of overlap of officers and directors between the organizations, as well as the industry sponsors. (Seymour and Compass also perform similar roles for the Florida Obstetric and Gynecologic Society and the Florida Society of Ophthalmology.)