April 17th, 2019
In the latest flagrant example of the close connection between government agencies and the drug industry, NBC recently reported that Demetra Ashley, the former acting assistant administrator of the U.S. Drug Enforcement Administration, is now a paid consultant for Purdue Pharma, one of the largest opioid-makers in the U.S.
At the DEA, it was Ashley’s job to try and prevent prescription drugs like opioids from being illegally diverted and sold. Purdue, on the other hand, knew that Oxycontin was being diverted to the black market and did not notify authorities, nor did they stop marketing their product once they knew it was addictive.
As hard as it may be to believe, there is nothing illegal about Ashley consulting for Purdue after leaving the DEA. In fact, the phenomenon of government agency workers leaving to work in the industry they once regulated is so common, it has its own nickname: the “revolving door.” Studies have documented the revolving door between industry and the FDA over the past decade; however, the issue is much larger than just the FDA. For example, more than 30 former Trump Administration officials are now industry lobbyists.
Some might argue that it’s good to have these connections between industry and government agencies, because former government agents can help private companies better follow the rules. For example, Ashley’s experience in preventing drug diversion could be used to help Purdue stop opioid drug trafficking. One could also argue that the potential for more lucrative work in the future helps bring the most talented people to government agencies.
However, the revolving door creates conflicts of interest, in which officials are asked to regulate companies that may one day pay them. It’s hard to believe that officials like Ashley will not be influenced by the knowledge that an industry job is waiting for them after they leave. “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,” said Dr. Vinay Prasad, hematologist-oncologist and researcher at Oregon Health and Science University, in Science Magazine.
Some may even regulate less strictly or “play nice” with industry, to increase their chance of getting an industry job in the future. The revolving door raises the question: “Did this person act differently in government because they anticipated or wanted to get the payday from these very powerful economic actors who have huge amounts at stake?” said Kathleen Clark, a law professor at Washington University, quoted in NBC.
Undoubtedly, there are many government officials who take their responsibility to regulate industry very seriously and are in no way swayed by the potential of a future industry job. Hopefully most agency workers feel and act this way. However, as long as the revolving door exists, there is no way to know how large of an influence these conflicts have, or how people are adjusting their behavior. Strangely, it’s similar to the mechanics of reality dating shows — how do you know who is “there for the right reasons” when everyone is offered lucrative deals after the show ends? Eliminating the financial conflict of interest is the only way to stop the cycle of harm from under-regulated drugs and devices.