The prevalence and influence of self-reported conflicts of interest by editorial authors of phase III cancer trials

Lerner, Tatiana Goberstein; Miranda, Michele da Costa; Lera, Andrea Thaumaturgo; Ueda, Aline; Briones, Bruna; Giglio, Auro del; Riechelmann, Rachel P.

doi:10.1016/j.cct.2012.05.011

Cited by 22 publications

(21 citation statements)

References 12 publications

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“…The majority of U.S. physicians receive gifts and/or direct compensation from drug companies , totaling $6.48 billion in 2015 . Financial relationships with industry are associated with changes in physicians’ interpretation of clinical trial results , clinical practice guideline recommendations , and prescribing of higher‐cost and/or brand‐name pharmaceuticals . Although a causal effect of industry payments has not been demonstrated, these findings have given credence to public concern over a perceived influence of the pharmaceutical industry on medical practice.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

et al. 2019

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Background Financial relationships between physicians and the pharmaceutical industry are common, but factors that may determine whether such relationships result in physician practice changes are unknown. Materials and Methods We evaluated physician use of orally administered cancer drugs for four cancers: prostate (abiraterone, enzalutamide), renal cell (axitinib, everolimus, pazopanib, sorafenib, sunitinib), lung (afatinib, erlotinib), and chronic myeloid leukemia (CML; dasatinib, imatinib, nilotinib). Separate physician cohorts were defined for each cancer type by prescribing history. The primary exposure was the number of calendar years during 2013–2015 in which a physician received payments from the manufacturer of one of the studied drugs; the outcome was relative prescribing of that drug in 2015, compared with the other drugs for that cancer. We evaluated whether practice setting at a National Cancer Institute (NCI)‐designated Comprehensive Cancer Center, receipt of payments for purposes other than education or research (compensation payments), maximum annual dollar value received, and institutional conflict‐of‐interest policies were associated with the strength of the payment‐prescribing association. We used modified Poisson regression to control confounding by other physician characteristics. Results Physicians who received payments for a drug in all 3 years had increased prescribing of that drug (compared with 0 years), for renal cell (relative risk [RR] 1.81, 95% confidence interval [CI] 1.58–2.07), CML (RR 1.22, 95% CI 1.08–1.39), and lung (RR 1.69, 95% CI 1.58–1.82), but not prostate (RR 0.97, 95% CI 0.93–1.02). Physicians who received compensation payments or >$100 annually had increased prescribing compared with those who did not, but NCI setting and institutional conflict‐of‐interest policies were not consistently associated with the direction of prescribing change. Conclusion The association between industry payments and cancer drug prescribing was greatest among physicians who received payments consistently (within each calendar year). Receipt of payments for compensation purposes, such as for consulting or travel, and higher dollar value of payments were also associated with increased prescribing. Implications for Practice Financial payments from pharmaceutical companies are common among oncologists. It is known from prior work that oncologists tend to prescribe more of the drugs made by companies that have given them money. By combining records of industry gifts with prescribing records, this study identifies the consistency of payments over time, the dollar value of payments, and payments for compensation as factors that may strengthen the association between receiving payments and increased prescribing of that company's drug.

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Section: Introductionmentioning

confidence: 99%

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

et al. 2019

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“…7 However, there has been a previous suggestion that FCOIs may lead to specific drug recommendations 8 or a favorable assessment of clinical trials. 9 COIs are an unavoidable component of the guideline development process, which begins with conducting a systematic review to gather an objective account of the existing body of evidence. Conversion of this body of evidence into a consensus recommendation, which is an essential step in the process, theoretically can be influenced by implicit biases among members with significant COIs.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, limited evidence exists regarding the effect of FCOIs on guideline recommendations 7 . However, there has been a previous suggestion that FCOIs may lead to specific drug recommendations 8 or a favorable assessment of clinical trials 9 …”

Section: Discussionmentioning

confidence: 99%

Financial conflicts of interest among National Comprehensive Cancer Network clinical practice guideline panelists in 2019

Desai

Chengappa

et al. 2020

Cancer

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BACKGROUND: Clinical practice guidelines (CPGs) are evidence-based guidelines that serve as a standard of care in oncology practice, reimbursements, and quality improvement initiatives. To our knowledge, the extent of financial conflicts of interest (FCOIs) in National Comprehensive Cancer Network (NCCN) guidelines have not been systemically evaluated. The current study evaluated the extent of FCOIs in the NCCN CPGs for the most common malignancies in the United States. METHODS: The authors examined the latest 2019 versions of the NCCN CPGs for the 10 most common cancers by incidence in the United States. Using disclosure lists, they catalogued the FCOIs for the panelists under various categories outlined in the CPG. The authors also tabulated the companies and institutions involved in each panel disclosure. An "episode" describes 1 instance of participation of a panelist in 1 company in 1 category of each guideline. "Affiliation" describes an industrial, commercial, or institutional affiliation reported by a panelist in each episode. RESULTS: Of the 491 panelists on the CPG panel, 483 (98.3%) completed FCOI disclosures. A total of 224 (46.4%) reported at least 1 FCOI episode. A total of 1103 episodes were disclosed with an average of 4.9 episodes reported per panelist with FCOIs. Acting as part of scientific advisory boards, as a consultant, or as an expert witness was the most common FCOI category (19.9%). A total of 191 companies were associated with 1103 episodes of FCOI. The top companies were Bristol-Myers Squibb, Merck, Genentech, and AstraZeneca. Among cancers, the prevalence of FCOIs was highest for lung cancer (56%), bladder cancer (52%), pancreatic cancer (52%), non-Hodgkin lymphoma (50%), kidney cancer (49%), colorectal cancer (43%), breast cancer (42%), melanoma (40%), prostate cancer (38%), and uterine cancer (32%). Among the panelists with FCOIs, 26%, 17%, and 57%, respectively, reported 1, 2, and >3 episodes. There were 127 episodes noted among the CPG chairs and/or vice chairs who reported FCOIs (mean, 6.4 episodes). The chairs and/or vice chairs of CPGs for uterine cancer, pancreatic cancer, melanoma, and prostate cancer were not found to have any FCOIs. CONCLUSIONS: FCOIs are very prevalent among NCCN CPG panelists. In nearly one-half of the CPGs, the majority of the panelists had at least 1 FCOI. Greater than one-half of the CPG chairs and/or vice chairs reported multiple FCOIs. Further research studies are necessary to determine the impact of these FCOIs.

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“…In that sense, meta‐research questions resemble those of systematic reviews, with the “participants, interventions, comparisons, and outcomes” framework used to develop focused questions. For example, we hypothesized that authors of editorials discussing phase III cancer trials could have their interpretation influenced by financial ties with pharma . Our objective was to evaluate the association between financial relationships and positive interpretation of editorial authors; our primary endpoint was to compare the proportion of authors with and without disclosure of any monetary gain from industry that interpreted the trial positively, regardless of its primary endpoint results; the population was composed of editorial authors who discussed phase III oncology trials published in top oncology journals during a decade.…”

Section: A Suggested Methodologymentioning

confidence: 99%

Meta-Research on Oncology Trials: A Toolkit for Researchers with Limited Resources

et al. 2018

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The term meta-research pertains to a type of study in which the unit of analysis is, in most cases, the publication of a clinical trial. This type of study usually provides a high-level picture of the literature on a specific topic, always accompanied by a critical evaluation of the methodology, design, and/or the quality of reporting of the studies included. Because relatively few resources are consumed to produce meta-research, these studies offer a great opportunity for clinical scientists who work in low-income countries. This article presents the principles of designing and conducting meta-research and proposes practical recommendations on how to perform and report this type of potentially very creative study.

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The prevalence and influence of self-reported conflicts of interest by editorial authors of phase III cancer trials

Cited by 22 publications

References 12 publications

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

Financial conflicts of interest among National Comprehensive Cancer Network clinical practice guideline panelists in 2019

Meta-Research on Oncology Trials: A Toolkit for Researchers with Limited Resources

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