A study published in JAMA this month, looks at meta-analyses (studies that statistically combine results from many individual trials). These are among the most influential papers published in medical journals. However, the study found they leave out a vital bit of information – financial conflicts of interest. Conflicts of interest relate to the funding of research and financial relationships with researchers by pharmaceutical companies.
A pharmaceutical company can exert data manipulation in a number of ways and the authors point out, unsurprisingly, that “compared with non-industry-funded trials, pharmaceutical industry funded studies more often yield results or conclusions in support of the sponsor’s drug, and author’s relationships with drug manufacturers have been linked to favourable assessments of drug efficacy and safety.” Researchers reviewed 29 published meta-analyses of drug treatments, which included data from 509 randomised controlled trials. They found none of the meta-analyses reported financial conflicts of interests of the authors of the original trials, and only two provided information on conflicts of interest regarding the trials’ funding sources – and this was hidden in very obscure places.
Worryingly, the team identified 7 meta-analyses where every single drug trial included was connected to the maker of the drug. “Few people would buy a car whose performance and safety had only been tested by the manufacturer or a house based only on the work of the seller without an independent inspection” said lead researcher Dr Brett Thombs, “yet most drugs that people take have been evaluated, for the most part, by the companies that produce them.” If this wasn’t bad enough, it has now emerged that two of the most prestigious international medical journals, the BMJ and the Lancet, are linked with Merck, a major pharmaceutical manufacturer, including the MMR vaccine. Merck has been quietly entering into partnerships with these journals under the guise of its subsidiary companies (Univadis and MSD).
It was the BMJ that ruthlessly attacked the integrity of Dr Wakefield during the MMR controversy – could this possibly have been influenced by a significant financial conflict of interest? “We didn’t declare these competing interests because it didn’t occur to us to do so” was the response from Fiona Godlee, editor-in chief, BMJ when challenged over the scandal. Apart from failing to disclose financial ties to Merck – through advertising and their learning division partnership – Godlee also acknowledges income from GSK, manufacturer of several vaccines as well. Adding to the controversy, this month a study published in the Canadian Medical Association Journal found that free journals with drug advertising were more likely to recommend certain drugs, as opposed to journals relying on subscription fees – which are more likely to recommend against the very same drugs. So, pharmaceutical companies are slipping through the backdoor, quietly creating a media monopoly with the power to distort scientific findings and shockingly exert their influence over the medical journals – the same journals that influence the decisions your doctor makes about your medical tests, procedures and treatments. You can learn more about this, and natural alternatives to many drugs, in my book Food is Better Medicine than Drugs.