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Company-sponsored trials tainting medicine: Researchers

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Trustworthy evidence. Surely it’s the bedrock of modern medicine.
 
But much company-backed research cannot be fully trusted, say leading medical researchers who have mounted a renewed challenge over the influence of commercial interests on research.
 
A new editorial published in The BMJ – Pathways to independence: Towards producing and using trustworthy evidence – brings together an international team of researchers, clinicians, regulators, and advocates to suggest how the profession can ‘start to build an evidence base for healthcare that is free of commercial influences’.
 
‘If we want to produce trustworthy evidence and tackle the epidemic of medical excess, decision-makers at all levels within healthcare need to disentangle themselves from those profiting from that excess,’ Dr Ray Moynihan, lead author of the editorial and Assistant Professor at Bond University, said.
 
According to Dr Moynihan and his fellow authors, the financial dependence of industry-funded research distorts results and leads to a situation in which company-sponsored studies overstate product benefits while downplaying harms.
 
‘We argue that endemic financial entanglement is distorting the production and use of healthcare evidence, causing harm to individuals and waste for health systems,’ they wrote.
 
Dr Moynihan uses the recent case of hundreds of Australian women experiencing serious pain and side effects from the use of transvaginal mesh implants as an example of industry influence.
 
‘In this case, poor testing meant many women received the mesh without knowing the risks of horrendous harms, including severe pain, infection, and repeated surgery,’ he wrote in The Conversation.
 
The BMJ group has proposed a number of potential pathways designed to create financial independence from commercial interests.
 
Research

• Governments require independent production of evidence used for healthcare decision making, including the evaluation of new treatments, tests, and technologies
• Governments require that public healthcare organisations, including regulatory and health technology assessment agencies, receive no industry funding and that their advisers have no financial relationships with industry
• Groups conducting research synthesis, including systematic reviews, ensure reviewers have access to all information on study methods and all relevant study results, including clinical study reports, and are conducted without industry funding and by authors with no financial relationships with companies that could benefit from the outcomes 

Education

• Professional, advocacy, or academic groups engaged in educational activities for health professionals, or the public, or advocacy affecting regulatory or policy decisions move to end reliance on industry funding and end financial relationships between their leadership and industry
• National governments work with professional associations and licensing bodies to develop policies that ensure educational activity supported by industry cannot contribute to accreditation of health professionals
• Medical journals and their editors move to end reliance on healthcare industry income 

Practice

• Professional groups, hospitals, health services, and governments prohibit marketing interactions between industry and decision-makers, including practising professionals, and actively support development of healthcare information independent of commercial interests
• Professionals, policy-makers, and the public move to reliance on practice guidelines produced and written by groups that have no financial relationships with industry and that have access to evidence, including research synthesis, free of industry influence
• Research funding bodies and academic institutions modify academic metrics and incentives explicitly to reward academic collaboration with public agencies and civil society groups as well as industry
• These proposed pathways arise from our analysis of the relevant evidence and examples from around the world

‘Patients and the public deserve to have evidence they can trust,’ BMJ Editor-in-Chief Dr Fiona Godlee said.
 
‘Commercial influence has no place in scientific research, nor in the education and guidance of clinicians, nor in decisions about diagnosis and treatment.
 
‘We hope that people around the world support our call for fundamental reforms.’
 
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BMJ commercial interests evidence research

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