April 6th, 2006

Hopkins Assailed for Tie to Product

By Julie Bell and Frank D. Roylance
Baltimore Sun

Deal lets maker of cosmetics use institution's name

Medical ethicists and others assailed Johns Hopkins Medicine yesterday for forming a financial relationship in which a retailer can use the Hopkins name in advertising skin-care products.

Hopkins says it isn’t endorsing the Cosmedicine line, which is sold in Sephora retail stores, including one at The Mall in Columbia. But Sephora’s Web site and marketing materials, which can include store window displays, promote the relationship.

The link could confuse consumers, ethicists and others said.

“Hopkins says they’re not endorsing the product, but they are; I don’t care what they say,” said Mildred Cho, associate director of the Stanford Center for Biomedical Ethics. “What is the consumer supposed to take away from the fact that Hopkins’ name is attached to this product?”

Cosmedicine’s skin collection includes a $35 foaming cleanser and toner, an $80 skin-fortifying serum that contains vitamins, a $48 moisturizer and a $45 eye cream to reduce puffiness and soften lines.

The terms of the agreement between Hopkins and Klinger Advanced Aesthetics, developer of Cosmedicine, were not disclosed. It is part of a trend in which academic medical institutions increasingly look to the private sector to help pay for their research and medical missions. For the most part, that revenue comes from companies that license the discoveries of academic scientists as a means of developing drugs or medical devices.

Universities derived $1.034 billion from licensing in 2004, the second-highest total ever, according to the annual Association of University Technology Managers survey, as reported in the Chronicle of Higher Education. The trend is happening as federal funds tighten and insurers cut payments. The highest total was $1.076 billion, during the tech boom of fiscal 2000.

With the Klinger deal, Hopkins is tapping into revenue from an industry that had $13.6 billion in U.S. sales of skin-care products in 2005, according to Kline & Company, a New Jersey-based market research firm. In all, the cosmetics and toiletries industry had retail sales of $48.7 billion last year.

This isn’t the first time an academic institution has made a deal with a cosmetics company. Japanese cosmetics maker Shiseido Inc. has had a 16-year relationship with Massachusetts General Hospital/Harvard Cutaneous Biology Research Center (CBRC), according to the center’s deputy director, Dr. Rebecca B. Campen.

The company paid for the renovation of research space for the center in Charlestown, Mass., and provided $9 million per year for dermatology research and the center’s administration.

In exchange, Campen said, Shiseido received rights to monitor the scientists’ work and to negotiate exclusive license agreements to develop the most promising results into skin care products.

But the Klinger deal is different, because no original Hopkins research is involved. Instead, faculty members helped design and review research on the products, which were launched in late February. Under the deal, Hopkins gets consulting fees, company stock and a board seat. Klinger gets to use Hopkins’ name prominently in advertising for Cosmedicine - including on the Sephora Web site.

“Truth is,” the Web site says in words that flash on the screen, then disappear, “it will achieve your highest skin health possible. ... Truth is, its performance is confirmed by Johns Hopkins Medicine.”

The advertising is part of a broader agreement between Hopkins and Klinger, which also has at least 11 centers that provide both cosmetic products and medical procedures, such as Botox injections. Hopkins previously offered advice to the company on how to safely perform procedures at the centers, Hopkins Medicine Dean Edward D. Miller said. The deals developed after Klinger Chairman Richard Rakowski approached Hopkins more than three years ago, Rakowski said.

About 10 Hopkins faculty were involved in designing clinical trials that tested various aspects of the Cosmedicine products, said Steve Libowitz, a Hopkins official who is a key liaison with the company. The faculty members then reviewed outcomes of the trials, but they didn’t conduct them. An outside firm did.

One of the tests Hopkins designed tested whether Global Health, a Cosmedicine sunscreen, runs when people sweat, making it more likely to get into their eyes and irritate them, Rakowski said. About 200 participants put on red-tinted sunscreen and sat in a hot room, and researchers measured how much the red ran. It didn’t, he said.

“If you’re doing the research yourself, that’s very different,” Miller said, reacting to criticism of the arrangement, which was first reported in yesterday’s Wall Street Journal. Hopkins and the company, he said, were simply applying scientific measurements to performance of skin-care products.

Rakowski said Hopkins does a fine job of balancing the need to raise money and ensuring it doesn’t cross ethical boundaries.

“They are not endorsing this product, nor have I asked them,” Rakowski said. “This is not Johns Hopkins skin cream. This is Johns Hopkins stepping in and creating a rational step in the marketplace for consumers.”

He added, “The controversy is not whether this is an ethics issue. The controversy is why hasn’t somebody done this before.”

But Dr. Amy Newberger, a practicing dermatologist in Scarsdale, N.Y., and former NIH researcher, called the Hopkins/Klinger affiliation “stunning. ... This is the weapon of mass promotion.”

“The university’s name is going to be used to promote this [product] ... to the exclusion of other, perhaps more effective products that have not previously forged a relationship with the university,” she said. “I don’t think this is fair and ... I don’t believe this is the function of a university.”

Hopkins’ ties to Klinger also concerns the Public Citizen Health Research Group, a Washington-based consumer watchdog organization founded by Ralph Nader. “I’ve never heard of anybody doing this before,” said Dr. Peter Lurie, the group’s deputy director.

“In effect, it’s an educational institution that’s willing to completely stray from its true function, which is to do education, research and to provide clinical services.”

Lurie described the work as dealing with “trivialities,” a characterization also made by Cho and Dr. Marcia Angell, a former editor of The New England Journal of Medicine.

“They ought to be doing research on serious things,” said Angell, who has written extensively about commercial-academic medical center ties. “You can’t evaluate the product that’s made by a manufacturer that’s hired you. The thing is riddled with conflict of interest.”

The arrangement also has been controversial within Hopkins, acknowledged Dr. Frederick Brancati, who heads the Division of General Internal Medicine and supports the deal. While licensing and consulting have long been part of academic medicine, he said this work seems trivial to some people in part because it involves skin care.

“But skin is an important part of health,” said Brancati, who hopes his division might get a six-figure sum from the deal to help fund its mission, which includes care for the poor. “Getting the right skin care products can help people protect their skin and feel better.”

Sephora provides thumbnail findings for some of the products. Its site says, for example, that a foaming cleanser provides a “43 percent decrease in oiliness immediately after application.”

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