Re: Guidelines for collaboration with industry should be transparent
Ben Goldacre asks how so many health professional organisations signed their names to guidelines for collaboration with the pharmaceutical industry which have since been recognised to be misleading and inaccurate. He says that none have offered an explanation. As the person who signed one of the documents on behalf of the BMJ, let me explain how this happened.
The BMJ approached the ABPI, who agreed to sponsor two co-branded seminars: the first on access to clinical trial data; the second on the role of industry in medical education. This was a new thing for the BMJ, working in partnership with a commercial sponsor. Both meetings went well, with lively debate from an invited audience.
The BMJ was not a member of the ESHLSG, had published an editorial critical of the first report from this initiative, and had not signed the group's earlier document on relations between doctors and industry. However, it was put to me that it would be good if the BMJ signed the clinical trial transparency guideline, which could then be launched at the first BMJ/ABPI seminar, the date of which had been chosen with this in mind. I read the document and thought it uncontroversial if unambitious. I was glad to see industry apparently engaging with these issues. I saw that other professional organisations had signed it. The meeting was fast approaching. The BMJ not signing the document would be awkward. I signed the document.
This was a mistake. As Sophie Arie's article explains, the document contained several importantly inaccurate statements which, as Ben Goldacre emphasises, gave false reassurance that all was well. As the BMJ continues to point out [bmj.com/open-data], all is not well.
For me this has been an important reminder of the need for vigilance against commercial influence and collegial chumminess. It is my second personal experience of "industry capture" - the first was with the tobacco industry in relation to articles I had written about the WHO. The latest episode has led me to clarify and strengthen our policy. "The BMJ accepts sponsorship and partnership at the Editor in Chief's discretion. Sponsorship is hands off: the journal retains full editorial control. We partner only with organisations with whom we share a common mission and values. The roles of all parties are fully declared."
I believe that the ESHLSG was, for many of those involved, a genuine attempt to make progress on the extraordinarily difficult question of how medicine and industry should interact. Its unravelling provides an object lesson in the need for transparency and independence, without which we will never achieve an evidence base for medicine that doctors and the public can trust.
1. Goldacre B. Guidelines for collaboration with industry should be transparent. BMJ 2013;347:f6100. (9 October.)
2. Collier J. Doctors, patients, and the pharmaceutical industry. BMJ 2009;338:b443.
3. Arie S. Doctors’ groups are criticised for endorsing pro-drugs industry guidelines. BMJ 2013:347:f6066. (9 October.)
4. Godlee F. WHO faces up to its tobacco links. BMJ 2000;321:314.
Competing interests: I am Editor in chief of the BMJ and a director of BMJ, which is a wholly owned subsidiary of the BMA. BMJ receives revenues from pharmaceutical and device manufacturers in the form of advertising, reprint sales, and sponsorship. I receive a bonus based in part on the financial performance of BMJ. The BMJ is an open access journal that charges author fees for publication of research articles. I have campaigned on issues of research transparency and integrity for quite a few years. The BMJ is a founding member of Alltrials.