A group of experts, policy makers, clinicians and citizen representatives from around the world are tackling the pervasive financial conflicts of interest in health research, education and clinical practice, proposing a better way forward.
More than half of medical research in the US is industry funded. Time and time again, it’s been shown that industry-funded trial outcomes favour their products, exaggerating benefits and downplaying harm, compared to independent studies.
Editors of leading medical journals have been scathing of biased research for at least a decade, and yet little has changed.
Former editor-in-chief of the New England Journal of Medicine, Marcia Angell, stood down in 2000, famously saying, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.”
Richard Horton, editor of The Lancet, similarly wrote that “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue.”
Big pharma’s tentacles spread to medical education with studies finding clear links between funding and promotion of sponsors’ drugs – their influence even extends to advocacy groups.
In clinical practice, sales representatives and direct payments are associated with greater prescribing of drugs from the company’s sponsors, and clinical guidelines are often written by people with financial interests in pharmaceutical companies.
These practices are leading to overdiagnosis and prescription of drugs, impacting people’s health and wasting money. Polypharmacy – taking five or more medicines a day – is common and has been increasing in older adults, with many detrimental outcomes.
Essentially, healthcare needs to become independent, they say.
“If we want to produce trustworthy evidence and tackle the epidemic of medical excess,” says lead author Ray Moynihan from Bond University in Queensland, Australia, “decision-makers at all levels within healthcare need to disentangle themselves from those profiting from that excess.”
To do this, they suggest governments call for independently funded research by scientists with no industry ties on new treatments, tests and technologies, and that public healthcare organisations accept no industry funding.
People and bodies involved in all aspects of medical education need to stop reliance on industry funding.
Marketing interactions between industry and decision makers also needs to be stopped, including healthcare professionals and clinical guideline authors.
The group suggests that research institutions could provide incentives for scientists to collaborate with public agencies and civil society groups.
They hope the reforms will reinstate public trust and improve healthcare outcomes.
“Patients and the public deserve evidence they can trust,” says Fiona Godlee, editor in chief of the BMJ.
“Commercial influence has no place in scientific research, nor in 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.”
By accessing their paper, published online in the BMJ, concerned people can sign to support their call to action.