The BMJ and its sibling journals have stopped publishing research funded by the tobacco industry for two main reasons: the research is corrupted and the companies publish their research to advance their commercial aims, oblivious of the harm they do. But these arguments apply even more strongly to research funded by the drug industry, and we suggest there is a better way to communicate the results of trials that would be safer for patients.
Prescribed drugs are the third leading cause of death, partly because of flaws in the evidence published in journals. We have long known that clinical trials funded by the drug industry are much more likely than publicly funded trials to produce results favourable to the company.The reason is obvious. The difference between an honest and a less than honest data analysis can be worth billions of euros, and the fraudulent trials of some cyclo-oxygenase-2 inhibitors for arthritis and selective serotonin reuptake inhibitors for depression are good examples.
There are many clever ways in which companies manipulate their research, and two recently published books give dozens of examples.
Flaws in the coding of adverse events can distort results without leaving any trace of what has happened, as we cannot get access to the raw data the drug companies hold. Three large trials of prasugrel, rosiglitazone, and ticagrelor made by Daiichi Sankyo and Eli Lilly, GlaxoSmithKline, and AstraZeneca, respectively, published in the New England Journal of Medicine were shown to be seriously misleading. Such biased selection by the sponsor of “unclear cases” of serious adverse events for review by an independent adjudication committee also corrupts the evidence base. Less cleverly, the companies publish favourable results in major journals and bury unfavourable ones. Half of trials are never published.