BMJ's CEO responds to Rory Collins' request for information about BMJ's revenues from the pharmaceutical industry
In response to a commentary drafted at COPE's request by BMJ's CEO, Mr Tim Brooks (http://www.bmj.com/content/bmj/suppl/2016/11/09/bmj.i4992.DC1/copedocume...), Rory Collins asked BMJ to declare how much revenue it receives from the pharmaceutical industry. Mr Brooks' reply is reproduced below for readers' information.
07 March 2016
Dear Professor Collins
You wrote to me on December 21st, in response to a commentary I drafted for COPE at their request in May 2015. Your letter asked that we declare how much revenue this company receives from the pharmaceutical industry.
BMJ is a private company with a single shareholder, and as such we do not publish detailed accounts. In the interests of meeting your concerns, however, here are the relevant data for last year.
In 2015, our financial records show that revenues from the industry totalled £7,481,000. This comprised 9.7% of our total revenue for 2015. It came from more than 200 companies in the sector, broadly defined. What this money bought was subscriptions to journals, of which we publish 60; advertising in the same; reprints of articles from the same; sponsorship of events (such as our International Forum on Quality & Safety in Healthcare); and sponsored translation and licensed distribution of our online learning resources.
It is not possible to state definitively that these are the only revenues received from pharma. For example, an individual working for a pharmaceutical company might take out a subscription to a relevant specialist journal in their own name, and reclaim the expense from their employer. More materially, some subscription agents - who sell on our behalf, and those of our competitors, in markets we cannot afford to service directly (for example, parts of Asia) will be selling subscriptions to pharma clients, but we have no way of finding this out directly.
What is safe to say is that even taking all of this uncertain revenue into account, the proportion of our income deriving from the pharmaceutical industry is below 15%. Our main sources of revenue are individual working doctors, and institutions such as medical schools and hospitals. The amount and proportion from pharma of course varies from year to year, but not by much; certainly not enough to change the overall picture.
Our biggest single client in the sector in 2015 spent £1.95m, which made up 2.5% of our total revenue. No other company (subject to the caveat above on traceability) spent more than £500K. That largest spender was Merck. I think it is worth dwelling on that for two reasons. Firstly, the majority of that spend was licensing of BMJ Learning content to Merck’s Univadis platform in a number of geographical territories, which has now ended. Secondly, as I do not need to remind you, Merck, according to your own declaration, has funded the Clinical Trials Support Unit to the extent of £219.7m over 20 years - comprising approximately 80% of your unit’s total declared funding.
Your letter went on to say, ‘it is worth commenting that, since statins are low-cost and generic, the financial interests of some companies may be best served by generating uncertainty about the safety of statins in order to encourage greater use of alternative, but much more costly, patented treatments. Consequently, in order that the BMJ not only demonstrates its commitment to transparency but also allows potential conflicts of interest to be properly assessed, please would you now release detailed data about all of the BMJ’s relevant financial interests?’ I think regular readers of The BMJ - which vigorously campaigns against over-diagnosis and unnecessary treatment - would not require reassurance about our readiness to challenge any unjustified expense from non-generic prescribing.
The final paragraph of your letter stated that ‘evidence is now emerging that - as was predicted in communications with The BMJ’s editor - erroneous statements about sideeffect rates in the BMJ papers by Abramson et al and by Malhotra have led to large numbers of high-risk patients stopping their statin therapy. It is very likely that the consequence of those actions will be heart attacks and strokes that could have been avoided.’ A central purpose of The BMJ, as a medical research journal, is to promulgate new thinking, and serve as the forum for debate around that thinking.
Those debates often spill over into the non-professional media. We believe this is fundamentally a good thing: matters as important as public health should not (and indeed cannot) remain the private preserve of experts. In this case, of course, it was principally your own action, in going to The Guardian to complain about the papers you refer to, that brought these questions about statins so vividly to the public notice; especially as the Guardian story was then followed up by the very popular and influential Today programme on BBC Radio 4. It was your choice to use these broadcast channels, rather than The BMJ. Let me state again for the record that on the very day you first complained about the original articles, our Editor in Chief asked you to write a response for publication; an invitation she has repeatedly reiterated. You have yet to do so.
Chief Executive Officer
Competing interests: Fiona Godlee is the editor of The BMJ and responsible for all that it contains.