The paper by Handel and colleagues (1) on journal reprint sales is very interesting, and we compliment the editors of BMJ and The Lancet for providing the authors with access to this important information. Unfortunately, the editors and owners of the big US journals, Annals of Internal Medicine, JAMA and New England Journal of Medicine were unwilling to share this information. Our experience, when we investigated journal income from reprint sales, was similar (2).

Much of the previous evidence in this field has been anecdotal. The infamous VIGOR trial of rofecoxib is a well-known example, where Merck bought 900,000 reprints from New England Journal of Medicine, estimated at an income for the journal of between US $700,000 and US $836,000 (3). However, the VIGOR trial was published more than 10 years ago and in the current study, a single Lancet paper with a similar sale of 835,100 reprints, amounted to a journal income of around US $2.4 million. It would be interesting to know which paper this was and whether its results and conclusions were reliable.

Handel and colleagues state that “Reprint orders represent a large source of income for the Lancet and BMJ”. While the BMJ’s reprint income is considerable, we believe that important differences exist between the two journals. The median number of reprints sold was almost ten times higher for The Lancet than for BMJ (1) and in our previous study we found that journal income from reprint sales, out of total income, was 3% for BMJ and 41% for The Lancet (2).

We believe that income from reprints creates conflicts of interest for journals, and a first step should be that editors disclose this information to journal readers, in just the same way that editors ask authors to disclose their conflicts of interest (4). However, disclosure does not eliminate the conflict. One alternative strategy could be not to publish the results of trials in journals but on public websites, and the role of journals could therefore be to discuss the results (5). A less radical approach would be only to publish trials in open access journals, where readers can read and print articles for free, as this would remove the journals’ income from reprint sales.

References

1. Handel AE, Patel SV, Pakpoor J, Ebers GC, Goldacre B, Ramagopalan SV. High reprint orders in medical journals and pharmaceutical industry funding: case-control study. BMJ 2012;344:e4212.

2. Lundh A, Barbateskovic M, Hróbjartsson A, Gøtzsche PC. Conflicts of interest at medical journals: the influence of industry-supported randomised trials on journal impact factors and revenue - cohort study. PLoS Med 2010;7:e1000354. Erratum in: PLoS Med 2011;8.

3. Smith R. Lapses at the new England journal of medicine. J R Soc Med 2006;99:380-2.

4. Jefferson T. Should journals sell reprints? No. BMJ 2011;343:d6448.

5. Smith R. Medical journals are an extension of the marketing arm of pharmaceutical companies. PLoS Med 2005;2:e138.

Competing interests: None declared