A former editor of the British Medical Journal (BMJ) has called for medical journals to ban the publication of research funded by pharma companies.
Richard Smith, who edited the journal for 13 years up to 2004, likened pharma-backed studies to the “corrupted” research undertaken by tobacco companies, which the BMJ no longer publishes.
Smith was writing in a head-to-head article for the BMJ, in which he and the Cochrane Collaboration's Peter Gøtzsche debate with the BMJ's deputy editor Trish Groves on whether journals should stop publishing such studies.
According to Smith and Gøtzsche, who has been an outspoken critic of the pharma industry's approach to transparency, pharma companies – like tobacco companies - cannot be trusted to provide research that isn't influenced by its commercial aims.
“We have long known that clinical trials funded by the drug industry are much more likely than publicly funded trials to produce results favourable to the company,” write the pair.
“The reason is obvious. The difference between an honest and a less than honest data analysis can be worth billions of euros.”
Smith and Gøtzsche provide several examples of this mistrust in practice, including flaws in the coding of adverse events and a bias in what studies companies submit for publication – selecting favourable results for major journals and “burying” less favourable ones.
The two also make the claims that some companies use ghost writers to promote misleading trials in secondary publications, giving readers a distorted view of the benefits and harms of drugs.
Defending the BMJ's decision to ban tobacco-backed research but keep publishing pharma research was the journal's Trish Groves, who said both industries have very different aims.
Whereas the pharma industry sells products aimed at improving health, the tobacco industry makes products that harm.
“Whatever your concerns about the drug industry and the safety of drugs, you'd be hard pushed to make the same allegation,” she writes.
Groves also commented on the BMJ's current policies, which require that any author wishing to submit a report for publication must commit to making anonymised patient level data available on request.
She did, however, call for the industry to do more to improve its trust standing by being more open, particularly with regards to transparency of trial data.
“How much can we trust the evidence base for drugs in current use?” asks Groves. “It's hard to tell, given the woeful legacy of widespread non-registration, non-publication, and selective reporting of clinical trials.”
This is in line with the BMJ's support of the AllTrials campaign to push for improved access to drug data, which has played its part mobilising recent moves from the likes of GSK towards greater transparency.
Groves also commented on the BMJ's desire to publish more negative trials that do not provide evidence of a drug's benefit as well as papers from the RIAT (Restoring Invisible and Abandoned Trials) initiative, through which academics can write up and publish previously unreported trials.
“Both these types of study can be much more useful to clinical practice than the placebo controlled trials that regulators demand.”
All three contributors are due to debate the issue live on Twitter on January 21 at noon using the hashtag #pharmaban.
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