The New England Journal of Medicine is concerned that doctors are unreasonably skeptical about pharma-funded clinical trials even when the methodology is strong. NEJM’s attitude bothered me, and in my prior post (Physicians are skeptical of pharma-funded research. Should we worry?) I cited three reasons I wasn’t concerned: 1) only the abstract was presented, which gave disproportionate weight to the disclosure, 2) physicians are rightly adjusting for the fact that less flattering studies may have been suppressed, and 3) filling out a survey about willingness to prescribe is one thing, but pharma has plenty of ways to make sure that valid research leads to more prescribing.
As I’ve thought about it further there are a couple other points I want to add:
- Industry sponsored studies are likely going to be about new drugs or new indications, whereas NIH might study a product that’s been on the market for a while and has a track record. I like the fact that physicians are skeptical of new drugs and more confident in those that have been around
- NEJM seems to be upset that readers don’t just trust what the journal editors and reviewers decide is meritorious and instead apply additional filters. But even with ideal policies in place, journals are still subject to the influence of pharma, which supplies articles for publication, pays for advertising, buys subscriptions and orders reprints