BMJ declares its revenues from industry
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4930 (Published 25 October 2017) Cite this as: BMJ 2017;359:j4930Click here to view annual updates of our sources of revenue
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Cunningham wonders about possible interaction between the BMJ and the vaccine industry. He notes your reluctance to discuss some recent question marks over the safety and effectiveness of the flu vaccine, at this time when huge sums of UK tax payer money are again being spent and distributed during the annual flu campaign. Not forgetting the extra appointments and nursing time required, to administer the flu vaccine, when primary care is seriously overstretched.
Most monies go to the vaccine companies, smaller but significant amounts go to GPs and pharmacies.
No one can be certain that their clinical judgment and enthusiasm are not affected by those payments.
A large poster outside our local supermarket reads “ Get your £10 flu jab here “.
Does the £10 fee include the provision of sufficient information to give fully informed consent in these post-Montgomery days ?
These concerns are not new, they were discussed by Doshi, in a BMJ Feature, four years ago, when he wrote,
“Promotion of influenza vaccines is one of the most visible and aggressive public health policies today...Closer examination of influenza vaccine policies shows that although proponents employ the rhetoric of science, the studies underlying the policy are often of low quality, and do not substantiate officials’ claims. The vaccine might be less beneficial and less safe than has been claimed, and the threat of influenza appears overstated.” (1)
Margaret McCartney expressed similar strong reservations in her BMJ column three years ago. (2)
It would be interesting to know if the evidence base for effectiveness, and the number of safety studies, have increased at the same rate as have vaccine industry profits, since Doshi and McCartney gave their views.
Some observers might consider that the reported negative effect of last winter’s over-65 flu vaccination campaign, and the safety concerns that Cunningham alludes to, have made flu vaccination campaigns more, rather than less, problematical.
Cochrane collaboration vaccine expert, Tom Jefferson has pointed out that “ Influenza vaccines are about marketing and not science,” so apart from the money, what do GPs have to gain from being involved in this annual campaign ? (3)
More importantly, what do most eligible patients have to gain, from the vaccine ?
1 BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3037
2 BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6182
3 https://www.theguardian.com/lifeandstyle/2014/oct/05/government-wrong-na...
Competing interests: No competing interests
Because you are able to evaluated the accuracy of advertising you should do this as a regular feature.
I would be happy to edit such a regular section.
Competing interests: serve as expert witness in toxic tort pharma and device litigation at the request of both injured patients and complainies.
I realise I made an error in my previous Rapid Response, and that the table does distinguish between journal revenue and group revenue. The other issues remain the same.
Competing interests: No competing interests
Is this the revenue for the group or the just for the journal, as obviously the prestige of the group and the journal are intertwined? In 2008 a partnership was announced between BMJ Learning and Merck [1]. Dr Godlee acknowledged the link in a reply to me in 2011 [2] but it is not clear whether the partnership still exists as it evidently did then. Can Dr Godlee update us and declare how much the group have received from this partnership?
Any information about revenue is evidently of limited value if we cannot see a breakdown of how much is being received from whom. It is not really news that BMJ receives revenue and this disclosure on its own may not do much to relieve the sense of opacity.
[1] https://www.investegate.co.uk/articlePrint.aspx?id=20080617122600NA464
[2] http://www.bmj.com/rapid-response/2011/11/03/response-john-stone
Competing interests: No competing interests
No one is better at holding industry's feet to the fire than The BMJ, but I confess to occasional dark thoughts about your interaction with the vaccine industry. Perhaps you have been intimidated by forecasts of "a tough flu season" and don't want to undermine the campaign for seasonal flu vaccine. Notably, you've said nothing about first trimester flu shots and significant increases in the risk of miscarriage (Donahue, Vaccine 2017;35:5314) and the risk of autism in the offspring (Hooker, JAMA Pediatr 2017;171:600); this, in the context of mounting evidence that flu shots work poorly: a 68% INCREASE in the risk of illness from H3N2 among the elderly (Public Health England 8/31/17).
In the US industry's web includes manufacturers, public health officials, doctors, journals, drugstores, politicians, etc, who consistently publicize good news about vaccines and ignore bad news. I hope for better than this from the UK.
In my better moments I recall some hard-hitting articles The BMJ has published about the limits of evidence for vaccine safety and effectiveness, in spite of any financial links to industry, and I hope you will continue.
Competing interests: No competing interests
Re: BMJ declares its revenues from industry
The revenue figures in this article relate to 2016. The corresponding figures for 2017 are now available on this page - https://www.bmj.com/about-bmj/sources-of-revenue - where annual updates will be posted.
Competing interests: No competing interests