Conflict of Interest Reporting by Authors Involved in Promotion of Off-Label Drug Use: An Analysis of Journal Disclosures
Background:
Litigation documents reveal that pharmaceutical companies have paid physicians to promote off-label uses of their products through a number of different avenues. It is unknown whether physicians and scientists who have such conflicts of interest adequately disclose such relationships in the scientific publications they author.
Methods and Findings:
We collected whistleblower complaints alleging illegal off-label marketing from the US Department of Justice and other publicly available sources (date range: 1996–2010). We identified physicians and scientists described in the complaints as having financial relationships with defendant manufacturers, then searched Medline for articles they authored in the subsequent three years. We assessed disclosures made in articles related to the off-label use in question, determined the frequency of adequate disclosure statements, and analyzed characteristics of the authors (specialty, author position) and articles (type, connection to off-label use, journal impact factor, citation count/year). We identified 39 conflicted individuals in whistleblower complaints. They published 404 articles related to the drugs at issue in the whistleblower complaints, only 62 (15%) of which contained an adequate disclosure statement. Most articles had no disclosure (43%) or did not mention the pharmaceutical company (40%). Adequate disclosure rates varied significantly by article type, with commentaries less likely to have adequate disclosure compared to articles reporting original studies or trials (adjusted odds ratio [OR] = 0.10, 95%CI = 0.02–0.67, p = 0.02). Over half of the authors (22/39, 56%) made no adequate disclosures in their articles. However, four of six authors with ≥25 articles disclosed in about one-third of articles (range: 10/36–8/25 [28%–32%]).
Conclusions:
One in seven authors identified in whistleblower complaints as involved in off-label marketing activities adequately disclosed their conflict of interest in subsequent journal publications. This is a much lower rate of adequate disclosure than has been identified in previous studies. The non-disclosure patterns suggest shortcomings with authors and the rigor of journal practices.
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Conflict of Interest Reporting by Authors Involved in Promotion of Off-Label Drug Use: An Analysis of Journal Disclosures. PLoS Med 9(8): e32767. doi:10.1371/journal.pmed.1001280
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1001280
Souhrn
Background:
Litigation documents reveal that pharmaceutical companies have paid physicians to promote off-label uses of their products through a number of different avenues. It is unknown whether physicians and scientists who have such conflicts of interest adequately disclose such relationships in the scientific publications they author.
Methods and Findings:
We collected whistleblower complaints alleging illegal off-label marketing from the US Department of Justice and other publicly available sources (date range: 1996–2010). We identified physicians and scientists described in the complaints as having financial relationships with defendant manufacturers, then searched Medline for articles they authored in the subsequent three years. We assessed disclosures made in articles related to the off-label use in question, determined the frequency of adequate disclosure statements, and analyzed characteristics of the authors (specialty, author position) and articles (type, connection to off-label use, journal impact factor, citation count/year). We identified 39 conflicted individuals in whistleblower complaints. They published 404 articles related to the drugs at issue in the whistleblower complaints, only 62 (15%) of which contained an adequate disclosure statement. Most articles had no disclosure (43%) or did not mention the pharmaceutical company (40%). Adequate disclosure rates varied significantly by article type, with commentaries less likely to have adequate disclosure compared to articles reporting original studies or trials (adjusted odds ratio [OR] = 0.10, 95%CI = 0.02–0.67, p = 0.02). Over half of the authors (22/39, 56%) made no adequate disclosures in their articles. However, four of six authors with ≥25 articles disclosed in about one-third of articles (range: 10/36–8/25 [28%–32%]).
Conclusions:
One in seven authors identified in whistleblower complaints as involved in off-label marketing activities adequately disclosed their conflict of interest in subsequent journal publications. This is a much lower rate of adequate disclosure than has been identified in previous studies. The non-disclosure patterns suggest shortcomings with authors and the rigor of journal practices.
Please see later in the article for the Editors' Summary
Zdroje
1. LexchinJ, BeroLA, DjulbegovicB, ClarkO (2003) Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ 326: 1167–1170.
2. BekelmanJE, LiY, GrossCP (2003) Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA 289: 454–465.
3. RidkerPM, TorresJ (2006) Reported outcomes in major cardiovascular clinical trials funded by for-profit and not-for-profit organizations: 2000–2005. JAMA 295: 2270–2274.
4. SageWM (2007) Some principles require principals: why banning “conflicts of interest” won't solve incentive problems in biomedical research. Texas Law Rev 85: 1413–1463.
5. Institute of Medicine, Board on Health Sciences Policy (2009) Conflict of interest in medical research, education, and practice. Washington, D.C.: NAS Press.
6. Harris G (26 Mar 2008) Cigarette company paid for lung cancer study. NY Times.
7. Meier B, Wilson D (17 Jul 2009) Medical school says former Army surgeon hid ties to Medtronic. NY Times. Available: http://www.nytimes.com/2009/07/15/business/15device.html. Accessed 10 July 2012.
8. ChimonasS, FroschZ, RothmanDJ (2011) From disclosure to transparency: the use of company payment data. Arch Intern Med 171: 81–86.
9. OkikeK, KocherMS, WeiEX, MehlmanCT, BhandariM (2009) Accuracy of conflict-of-interest disclosures reported by physicians. NEJM 361: 1466–1474.
10. RadleyDC, FinkelsteinSN, StaffordRS (2006) Off-label prescribing among office-based physicians. Arch Intern Med 166: 1021–1026.
11. WaltonSM, SchumockGT, LeeKV, AlexanderGC, MeltzerD, StaffordRS (2008) Prioritizing future research on off-label prescribing: results of a quantitative evaluation. Pharmacotherapy 28: 1443–1452.
12. SteinmanMA, HarperGM, ChrenMM, LandefeldCS, BeroLA (2007) Characteristics and impact of drug detailing for gabapentin. PLoS Med 4 (4) e134 doi:10.1371/journal.pmed.0040134.
13. ChenH, DeshpandeAD, JiangR, MartinBC (2005) An epidemiological investigation of off-label anticonvulsant drug use in the Georgia Medicaid population. Pharmacoepidemiol Drug Saf 14: 629–638.
14. KesselheimAS, StuddertDM (2008) Whistleblower-initiated enforcement actions against health care fraud and abuse in the United States, 1996–2005. Ann Intern Med 149: 342–349.
15. Weber T, Ornstein C (16 Sept 2011) Doctors avoid penalties in suits against medical firms. Available: http://www.propublica.org/article/doctors-avoid-penalties-in-suits-against-medical-firms. Accessed 28 May 2012.
16. KesselheimAS, MelloMM, StuddertDM (2011) Strategies and practices in off-label marketing of pharmaceuticals: a retrospective analysis of whistleblower complaints. PLoS Med 8 (4) e1000431 doi:10.1371/journal.pmed.1000431.
17. United States Department of Justice. Office of Public Affairs Press Releases. Available: www.usdoj.gov/03press/03_1_1.html. Accessed 28 May 2012.
18. LexisNexis. Total research system. Available: http://www.lexisnexis.com/en-us/home.page. Accessed 28 May 2012.
19. United States Judiciary. Public Access to Court Electronic Records. Available: http://pacer.psc.uscourts.gov/. Accessed 28 May 2012.
20. National Center for Biotechnology Information. PubMed. Available: http://www.ncbi.nlm.nih.gov/pubmed/. Accessed 28 May 2012.
21. International Committee of Medical Journal Editors. ICMJE Form for Disclosure of Potential Conflicts of Interest. Available: http://www.icmje.org/coi_disclosure.pdf. Accessed 28 May 2012.
22. KratochvilCJ, VitielloB, BrentD, BosticJQ, NaylorMW (2006) Selecting an antidepressant for the treatment of pediatric depression. J Am Acad Child Adolesc Psychiatry 45: 371–373.
23. WaliRK, MohanlalV, RamosE, BlahutS, DrachenbergC, PapadimitriouJ, et al. (2007) Early withdrawal of calcineurin inhibitors and rescue immunosuppression with sirolimus-based therapy in renal transplant recipients with moderate to severe renal dysfunction. Am J Transplant 7: 1572–1583.
24. FungJJ (2004) Tacrolimus and transplantation: a decade in review. Transplantation 77: S41–S43.
25. KellyDM, DemetrisAJ, FungJJ, MarcosA, ZhuY, SubbotinV, et al. (2004) Porcine partial liver transplantation: a novel model of the “small-for-size” liver graft. Liver Transplant 10: 253–263.
26. BosticJQ, SchlozmanS, PatakiC, RistucciaC, BeresinEV, MartinA (2003) From Alice Cooper to Marilyn Manson: the significance of adolescent antiheroes. Acad Psychiatry 27: 54–62.
27. Altman DG (1991) Practical Statistics for Medical Research. London, UK: Chapman and Hall.
28. Thomson Reuters. ISI Web of Knowledge Web site. Available: http://www.isiwebofknowledge.com. Accessed 28 May 2012.
29. R Development Core Team (2011) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.
30. Harris G, Carey B, Roberts J (10 May 2007) Psychiatrists, children, and the drug industry's role. NY Times. Available: http://www.nytimes.com/2007/05/10/health/10psyche.html?pagewanted=all. Accessed 10 Jul 2012.
31. WeinfurtKP, SeilsDM, TzengJP, LinL, SchulmanKA, CaliffRM (2008) Consistency of financial interest disclosures in the biomedical literature: the case of coronary stents. PLoS ONE 3 (5) e2128 doi:10.1371/journal.pone.0002128.
32. DrazenJM, de LeeuwPW, LaineC, et al. (2010) Toward more uniform conflict disclosures – the updated ICMJE conflict of interest reporting form. NEJM 363: 188–189.
33. BlumJA, FreemanK, DartRC, CooperRJ (2009) Requirements and definitions in conflict of interest policies of medical journals. JAMA 302: 2230–2234.
34. KesselheimAS, LeeJL, AvornJ, ServiA, ShrankWH, ChoudhryNK (2012) Conflict of interest in oncology publications: A survey of disclosure policies and statements. Cancer 118: 188–195.
35. RiechelmannR, WangL, O'CarrollA, KrzyzanowskaM (2007) Disclosure of conflicts of interest by authors of clinical trials and editorials in oncology. J Clin Oncol 25: 4642–4647.
36. SternS, LemmensT (2010) Legal remedies for medical ghostwriting: imposing fraud liability on guest authors of ghostwritten articles. PLoS Med 8 (8) e1001070 doi:10.1371/journal.pmed.1001070.
37. ChimonasS, PattersonL, RaveisVH, RothmanDJ (2011) Managing conflicts of interest in clinical care: a national survey of policies at U.S. medical schools. Acad Med 86: 293–209.
38. RockeySJ, CollinsFS (2010) Managing financial conflict of interest in biomedical research. JAMA 303: 2400–2402.
39. WadmanM (1 August 2011) Conflict disclosure plan dropped. Nature 476: 17 doi:10.1038/476017a.
40. TatsioniA, SiontisGC, IoannidisJP (2010) Partisan perspectives in the medical literature: a study of high frequency editorialists favoring hormone replacement therapy. J Gen Intern Med 25: 914–919.
41. WangAT, McCoyCP, MuradMH, MontoriVM (2010) Association between industry affiliation and position on cardiovascular risk with rosiglitazone: cross sectional systematic review. BMJ 340: c1344 doi:10.1136/bmj.c1344.
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