Sloan Kettering, INC

By

Leonard Zwelling

https://www.nytimes.com/2018/09/20/health/memorial-sloan-kettering-cancer-paige-ai.html?rref=collection%2Fsectioncollection%2Fnyregion&action=click&contentCollection=nyregion&region=stream&module=stream_unit&version=latest&contentPlacement=10&pgtype=sectionfront

On the front page of the NY Times on September 21, 2018, Memorial Sloan-Kettering was again outed by the Times and ProPublica. This time it was for forming a company that will use the images of the pathology specimens accumulated over the years to analyze with artificial intelligence. Apparently there are questions about the commercialization of the work of the MSKCC pathologists for the benefit of a few (the Chief of Pathology and other faculty members plus members of the MSKCC board). Here we go again. Those guys in New York City just can’t help themselves. If they see a way to make money by using the resources of the non-profit that pays them, they will. There is also the issue of confidentiality and whether or not consent was really granted by all the people whose clinical material stock the vaults of MSKCC Pathology. MSKCC itself has a 9% stake in the company as well.

Here’s the deal.

If Sloan-Kettering wants to mine its data for the benefit of humanity, please go ahead. If it wants to commercialize the work of its faculty without allowing them to share in the benefits, my guess is the faculty won’t be too happy. For the board to share in this profit-making (of course they will recuse themselves from all votes concerning the company) looks awful. Basically, what is supposed to be a non-profit is being converted into a profitable corporation. And, by the way, everyone is doing it.

The Bayh-Dole Amendment of 1980 allowed the commercialization of discoveries made using federal funding by academia and every dean got dollar signs in his or her eyes looking for the next Gatorade.

This legislation was a bad idea and it has flowed to its inevitable conclusion where what is supposed to be altruistic discovery (often taxpayer-supported) has morphed into competition with the drug companies. As the Baselga case shows us (until his resignation he was the chair of the scientific board of this new start-up), there really is no limit to what people will do if society relies on academics’ own ethics to govern their behavior. That’s why there are rules, regulations and laws. And when they are broken, punishment is appropriate.

This latest case is simply about greed and the use of what was a public trove for private gain. Apparently there was no competitive bidding for the use of the resources of MSKCC pathology. It said in the article that those cooking up this scheme couldn’t raise the capital in the venture markets. Thus the need to tap out the board.

Let’s keep the operations and governance of the non-profits separate from the money-making concerns of private industry.

Is there any wonder why the American public express more doubt in their physicians? Why trust people who would use the resources gained under the pretext of helping patients for their personal profit?

If a non-profit health care delivery system wants to sell its resources for commercialization purposes, it needs to do so with the proviso that all profits go back to the patients and even then, I have grave reservations about the use of patient material to benefit those who were caring for those patients.

I know this is a hard world right now for academic medical centers. Reimbursement for clinical services is under downward pressure. Philanthropy is always hard and the NIH budget hasn’t jumped all that much. It is only to be expected that these academic institutions would look to the private sector for more money—a new revenue stream. But are they still non-profit institutions with the tax advantages that come with this designation? I think not.

If the academic institutions want to go into the marketplace to compete with biotech and big pharma, they can. But they are not going to be able to claim identity as the non-taxed arbiters of truth. They are just another company in competition for commercial dollars. To quote Agent Orange: “Sad.”

Leonard Zwelling