One in five of the Australian medical experts tasked with deciding which drugs are recommended for use by doctors have undisclosed links to drug companies, an investigation has found.
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In a paper published in the journal BMJ Open on Tuesday, the report’s authors identified 83 experts with potential conflicts of interest that they had not disclosed, out of a total of 402.
Bond University academic researcher Dr Ray Moynihan, one of the report’s authors, said in many cases there was no actual requirement for the experts in question to disclose their conflicts of interest.
“They didn’t do anything illegal, and in fact were probably doing what they thought was the right thing,” Dr Moynihan said.
“The point of the study is to throw a light on this issue and the results suggest that we need much more transparency about these ties.
“But also it raises the wider question of whether it’s appropriate to have any ties, disclosed or undisclosed.”
Guidelines are relied on by doctors to inform how they treat various conditions, including advice on which drugs work best according to current medical wisdom.
The experts with undisclosed ties to drug companies were spread across 23 out of the 33 guidelines looked at by the investigation, representing 10 key health areas.
“These are not marginal guidelines; these are guidelines which influence how Australian doctors treat patients every day,” Dr Moynihan said.
The ties in question could range from having worked on research projects paid for by a drug company, to having accepted money from the drug company to advocate for their products.
Another of the report’s authors, Professor Lisa Bero from the University of Sydney, said there were probably far more experts who had worked on guidelines who had undisclosed conflicts of interest, with the 400-odd sampled for the investigation just a fraction of the thousands who have contributed to guidelines.
“There’s a lot of methods by which people develop guidelines, and when I see undisclosed financial ties, it makes me wonder exactly what method they were using to develop those guidelines,” Professor Bero said.
“We definitely need to increase transparency.”
Professor Bero said since they had started the investigation, the National Health and Medical Research Council had tightened its rules around disclosure of conflicts of interest to what she described as one of the strictest reporting frameworks in the world.
“They say that ideally none of the members of a guideline panel should be conflicted at all,” she said.
“That is a very high standard and would definitely be the ideal. You definitely could eliminate conflicts from the guideline panels.
"In the absence of that, we really need to be ensuring that people are disclosing (their conflicts)."
The investigation discovered many of the conflicts of interest by looking at publications by the experts in question in various medical journals, which had stricter reporting standards for conflicts of interest.
It did not investigate if there were any undisclosed conflicts of guideline writers who had already disclosed conflicts in the sample of guidelines analysed, meaning the number of undisclosed conflicts could be even higher.
The report's authors said the results showed there needed to be greater scrutiny of ties between industry and academia, which was often encouraged by governments and could lead to good outcomes, but which opened the door for conflicts of interest.
