Medical journals are crucial in scientific discourse, with editors playing a significant role in the peer-review process. However, there is a growing concern in the industry regarding the financial ties between Big Pharma and medical publications, which may be affecting the integrity of the review process.
In recent years, scientific publications have witnessed an “alarming” increase in clinical trials permitted based on poor or inconclusive data, Science Alert reports. What’s more, hundreds of articles in medical journals claiming to be authored by accredited physicians have turned out to be authored by paid writers.
This is obviously concerning. But this may just be a symptom of a much bigger and systemic problem, plaguing the scientific community.
The good news is the United States has upped their efforts to increase the transparency of physician conflicts of interest (COI), by creating a Federal program dubbed Background Open Payments, designed to mandate reporting of medical industry payments to physicians.
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But while this payment practice between industry and journal editors is legal, recently published studies reveal that the problem is only growing.
Big pharma, big dollars
In 2018, the American Association for the Advancement of Science (AAAS) performed an analysis based on a 2010 FDA panel meeting to discuss a new drug designed to help prevent heart attacks and strokes by limiting blood clotting, dubbed Brilinta. The analysis, which used disclosures in freely available publications found on the Federal Background Open Payments website, examined direct payments made to FDA advisors by firms whose drugs were being voted on for approval.
During the investigation, they discovered that 37% (40/107) of the physician advisers who voted on the committee’s panel received more than $10,000 across a four-year period from Big Pharma. 26 advisors gained more than $100,000, and six more than $1 million. Of the close to $25 million in personal payments or “research support,” the 16 top-earning advisers received more than $300,000 each.
Most of those top earners—and many others—received other funds from those same companies, concurrent with or in the year before their advisory service. Those payments were disclosed in scholarly journals, but not by FDA.
The British Medical Journal (BMJ) also conducted a peer-reviewed study examining payments made to editors of the world’s most influential medical journals from industry sources. Of the journals that were eligible for payment, over 50% of editors received money from the pharmaceutical industry – in some cases, hundreds of thousands of dollars.
Furthermore, in 2019, a four-year-long peer-reviewed study published by PLOS examined 35 different journals and concluded that a significant number of editors received payment during the study period (August 1, 2013, to December 31, 2016). The study found that 447 of the “top tier” editors of 35 journals met the payment inclusion criteria.
In 2022, the Radiological Society of North America (RSNA) conducted a study titled “Health Care Industry Payments to Editorial Board Members of Imaging-related Journals.” The study reviewed a total of 519 editorial board members. They found that out of the 305 journals studied, 214 received industry payments.
These payments made to editorial board members ranged from $12.63 to $404, 625.47. Interestingly, the study concluded that imaging-related journals “often do not report or do not accurately report payments from industry to their editorial board members.”
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Biggest fines in history
To give the consequence of industry influence over medical journals some context, it’s important to highlight recent civil and criminal controversies surrounding Big Pharma.
In 2004, pharmaceutical giant Merck pulled the drug Vioxx from the market after it was revealed that the company had withheld information about the dangers of the drug from both physicians and patients for more than five years. It is believed that Vioxx caused between 88,000 and 140,000 cases of severe heart disease and killed many thousands of people. Some even claim the death toll could be as high as 500,000.
Pfizer was fined US$2.3 billion in 2009, the largest healthcare industry fine imposed in the US at the time, after pleading guilty to misbranding their painkiller, Bextra, with ‘’the intent to defraud or mislead.’’ The company promoted the drug to treat acute pain at dosages the FDA had previously deemed dangerously high.
In 2012, GlaxoSmithKline (GSK) agreed to pay a fine of US$3 billion to resolve civil and criminal liabilities in regard to misbranding the drug, Paxil, for treating depression in patients under 18, even though the drug had never been approved for that age group. The company also failed to report safety data. This is the largest healthcare fraud settlement in the US to date.
Furthermore, in 2013 Johnson & Johnson agreed to pay a US$2.2 billion fine to resolve criminal and civil allegations relating to the marketing of prescription antipsychotic drugs Risperdal, Invega and heart drug Natrecor. The company’s conduct was deemed to have “recklessly put at risk” children and dementia patients, Reuters reports.
The list goes on and on.
Big pharma, little media
These fines and medical journal industry payments have gone on under people’s noses with little to no media attention. One explanation could be that major pharmaceutical players pay billions in advertising revenue to the mainstream media every year. But there might be another – which goes right up to Washington.
On August 12th, 2022, the Democratic Senate passed the US$430 billion bill Inflation Reduction Act, aimed at “conquering” climate change, raising tax rates, and lowering medical and pharmaceutical costs for elderly Americans.
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The Senate supported the bill by arguing Big Pharma’s aggressive prescription drug price hikes were contributing to the inflation problem. Big Pharma campaigned against this by arguing prescription drugs do not contribute to inflation, citing an average 2.5% rise.
Funnily enough, Big Pharma spent more money than any other industry to lobby Congress and Federal agencies in 2022. The industry’s powerful trade association, Pharmaceutical Research and Manufacturers of America (PhRMA), urged senators in a public letter to reject the bill.
An OpenSecrets analysis of lobbying and campaign contribution data shows that the pharmaceutical industry spent at least $142.6 million on lobbying Congress and Federal agencies in the first half of 2022. Along with $16.1 million on campaign contributions during the midterm election cycle that started in January 2021. That’s more money than any other industry.
It’s no wonder 27% of Americans hate Big Pharma. In fact, it was the second most hated industry in America in 2019, Business Insider reports. So, what can we take away from this?
Big Pharma has a big interest in lobbying Congress to reduce the industry’s financial burden when it comes to new drug development. But the industry doesn’t just influence politicians, it also pays off influential physicians and journal editors to influence their decision-making. And by going off the opinion data alone, the masses are sick and tired of Big Pharma’s corrupt practices.