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Editorials

Commercial interests, transparency, and independence: a call for submissions

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1706 (Published 16 April 2019) Cite this as: BMJ 2019;365:l1706

Commercial influence in health: from transparency to independence

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  1. Ray Moynihan, assistant professor1,
  2. Helen Macdonald, UK research editor2,
  3. Carl Heneghan, professor,
  4. Lisa Bero, professor4,
  5. Fiona Godlee, editor in chief2
  1. 1Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
  2. 2The BMJ, London, UK
  3. 3Nuffield Department of Primary Care, Oxford University, Oxford, UK
  4. 4Charles Perkins Centre, University of Sydney, Sydney, Australia
  1. Correspondence to: R Moynihan raymoynihan{at}bond.edu.au

Help the move towards independence from commercial interests

A decade ago the US Institute of Medicine (IOM) issued a landmark report on conflicts of interest in research, medical education, and practice.1 Highlighting benefits of collaborations between physicians, researchers, and companies to develop new products that can improve health, the report also raised substantial concerns that extensive financial ties could unduly influence professional judgments. It concluded these financial conflicts of interest could jeopardise the integrity of science, the objectivity of education, the quality of care, and public trust in medicine. The report recommended more research on conflicts of interest, improvements in transparency, and greater independence from industry.

Today we announce plans for a stream of BMJ content to revisit these concerns and ask you to join us. A key aim is to identify and respond to commercial influences on health and healthcare, to understand under what circumstances involvement with industry is truly necessary. Where it is not necessary, we want to forge a new independence from those who make and sell products, to strengthen trust in how evidence is produced and disseminated, and to drive more rational and safer use of drugs, devices, diagnoses, and data in the public interest.

Problematic relationships

Since the 2009 IOM report, transparency has improved, but key recommended steps towards independence—such as prohibiting free meals, excluding conflicted authors from guidelines, and ending industry influenced medical education—have not been taken. These practices are still widespread despite continuing evidence of distorting impacts on research and practice. A 2010 cross sectional review found that the views of “key opinion leaders” strongly correlate with their sponsor’s interests.2 A 2016 study of 279 000 physicians, using the new US Open Payments transparency initiative (https://www.cms.gov/openpayments/), found an …

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