Earlier this year, a report in the New England Journal of Medicine combed through clinicaltrials.gov, looking to see how quickly after completion trials were reported. It found that, after the legal maximum of a year was up, just 17% of those paid for by industry had had their results published. Drug firms were not, though, the worst offenders. Only 8.1% of trials paid for by the National Institutes of Health, the American government’s main conduit for medical-research money, were reported within a year. And just 5.7% of the ones paid for by other government agencies and academic institutions were (see chart). Moreover, even though the Food and Drug Administration (FDA), the agency which monitors the website, has the power to fine companies that do not comply, it has never actually done so. More here.
The decision by The BMJ to further try to enforce its separation from industry is somewhat at odds with the essentially wholly private sector leadership of pharmaceutical R&D. The lay perception of the #BMJ might be of a respected medical journal, but in fact it’s a USD120m+ revenue international publishing enterprise with 50+ journals. While potential conflicts of interest are important to consider, assess and account for, to assume that industry connectedness is entirely or even somewhat negative is shortsighted and destructive given the increased complexity of R&D. And The BMJ is part of that same health care industry, happily profiting off its back. To put in place yet more barriers to prevent leading investigators articulating the clinical meaningfulness of their trials is surely counter productive. As they address diseases ever more specifically and in ever smaller more segmented patient cohorts, it seems folly to try to stymie the debate that should ensue from these trials’ findings. The BMJ seems to have overlooked the fact of the multi million dollar business that it has become, that open access is increasingly democratising science, that peer review should be about what you’ve done not who you are, and that Impact Factors aren’t perhaps what they once were.