So what if cancer researchers have close financial ties to Big Pharma? Scientists have to disclose their associations with drug companies when they publish research in respected journals and they’d never let a little thing like financial ties influence how they interpret outcomes or run a study. Right?
Not exactly. In fact, a new analysis by University of Michigan (U-M) Comprehensive Cancer Center researchers just published in the online version of the journal CANCER, a peer-reviewed journal of the American Cancer Society, found that a very large number of clinical cancer studies published in well-known medical journals have financial connections to pharmaceutical companies. Most importantly, the study flat out concludes that conflicts of interest may cause some researchers to report results that are biased to be favorable to Big Pharma companies.
“Given the frequency we observed for conflicts of interest and the fact that conflicts were associated with study outcomes, I would suggest that merely disclosing conflicts is probably not enough. It’s becoming increasingly clear that we need to look more at how we can disentangle cancer research from industry ties,” study author Reshma Jagsi, M.D., D.Phil., assistant professor of radiation oncology at the U-M Medical School, said in a media statement.
Entanglements and alliances between clinical researchers and companies that make medical devices and medications have become increasingly complicated, especially in the face of more and more scientists competing for fewer and fewer federal research funds. Out of necessity, scientists have turned to financial support from Big Pharma. But apparently there could be strings – and lures – attached.
For example, many researchers get additional consulting fees and also end up owning a part of a drug company themselves, through stock purchases and/or by holding salaried positions within medical industries. In other words, they profit from sales if the very products and drugs they test do well.
You don’t have to be a business insider to figure out this type of conflict of interest should raise concerns and suspicions that research tied closely to industry might be biased and not designed to produce the most accurate test of medical therapies. That’s why most medical journals now require investigators to disclose all potential conflicts of interest in the studies and reviews they submit for publication.
But is voluntary disclosure enough? And does that somehow make a conflict of interest less likely?
Nearly one-third of cancer studies had financial conflicts of interest
To document how frequently conflict of interests in clinical cancer research might occur, Dr. Jagsi and colleagues reviewed cancer studies that were published in 2006 in the New England Journal of Medicine, the Journal of the American Medical Association (JAMA), Lancet, the Journal of Clinical Oncology, the Journal of the National Cancer Institute, Lancet Oncology, Clinical Cancer Research and CANCER.
Out of the 1,534 cancer studies identified, nearly a third, 29 percent, had conflicts of interest that were, in fact, fairly obvious from a review of the published studies authors’ declarations and authorship lists (which included medical industry funding, consulting fees to the researchers, co-authorship by industry employees, etc.). Some 17 percent had direct industry funding. The conflicts of interest found most often, according to the current CANCER study, were in articles with primary authors from medical oncology departments (45 percent), who were based in North America (33 percent), and those with male first and senior authors (37 percent).
Perhaps the most disturbing part of the CANCER study was the fact randomized clinical trials that supposedly assessed patient survival were found to be more likely to report a survival advantage associated with a medical intervention (such as a prescription drug, diagnostic tests or new technologies) when a conflict of interest was present. This could have very serious consequences for patients because trials reported in prestigious journals are the basis by which various treatment modalities, including prescription drugs, get approved for use by clinicians.
Bottom line: studies steered to report a survival advantage where there might not really be one are unfairly and perhaps dangerously shaping the way oncologists treat cancer patients.
In addition, the findings also show medical industry-funded studies were more likely to focus on ways to treat than studies without industry funding (62 percent vs. 36 percent). They were far less likely than studies not hooked to medical industry funding to concentrate on epidemiology, prevention, risk factors, screening or diagnostic methods.
“In light of these findings, we as a society may wish to rethink how we want our research efforts to be funded and directed. It has been very hard to secure research funding, especially in recent years, so it’s been only natural for researchers to turn to industry. If we wish to minimize the potential for bias, we need to increase other sources of support. Medical research is ultimately a common endeavor that benefits all of society, so it seems only appropriate that we should be funding it through general revenues rather than expecting the market to provide,” Dr. Jagsi said in a statement to the media.
Source: “Frequency, nature, effects, and correlates of conflicts of interest in published clinical cancer research.” Reshma Jagsi, Nathan Sheets, Aleksandra Jankovic, Amy R. Motomura, Sudha Amarnath, and Peter A. Ubel. CANCER; Published Online: May 11, 2009 (DOI 10.1002/cncr.24306) Print Issue Date: June 15, 2009.