New England Journal of Medicine and conflict of interest

The New England Journal of Medicine will announce Thursday that it has given up finding truly independent doctors to write and review articles and editorials for it, as a result of the financial ties physicians have with so many drug companies in the United States The Journal says the drug companies' reach is just too deep.

A Medical Journal Eases Conflict Rule

The New England Journal of Medicine is relaxing its strict conflict-of-interest rules for authors of certain articles because it cannot find enough experts without financial ties to drug companies.

The New England Journal of Medicine Loosens Conflict-of-Interest Rules

In this week's issue of The New England Journal of Medicine, the editors announced a change in journal policy that will allow experts to comment on the effectiveness of a drug or device, even when they have a financial tie to the maker of the product under review.

According to Journal Editor-in-Chief Dr. Jeffrey M. Drazen and Executive Editor Dr. Gregory D. Curfman, the new rules do not apply to original articles. In those cases, the journal discloses the study's funding and the financial interests of the researchers, and that won't change.

But they are changing rules applying to authors of review articles and editorials.

Drs. Drazen and Curfman believe previous rules barring experts with any financial ties to private companies linked to drugs reviewed in journal articles were too restrictive. "For example, in the past two years we have been able to solicit and publish only one Drug Therapy article on a novel form of treatment," they write, adding that while the avoidance of conflict of interest is important, "our silence does not serve our readers."

The NEJM editorial board "concluded that our ability to provide comprehensive, up-to-date information, especially on recent advances in therapeutics, has been constrained" by a policy which stated that the authors of review articles and editorials "will not have any financial interest in a company (or its competitor) that makes a product discussed in the article."

The policy has now been changed to read that the authors of these types of articles will not have any "significant" monetary ties to private companies that might stand to gain from a review article in the Journal.

"The addition of the word 'significant' acknowledges that not all financial associations are the same," Drs. Drazen and Curfman write. For example, experts who simply have invested in a mutual fund that might include a drug company linked to the product under review will now be allowed to write a review article on that drug for the Journal.

And the editors base their definition of "significant financial interest" on guidelines issued by the US National Institutes of Health and the Association of American Medical Colleges, which set the amount at $10,000 in any given year.

New England Journal loosens its rules on conflict of interest

The New England Journal of Medicine is relaxing its longstanding rules on conflict of interest so that it can publish evaluations of new drugs by researchers with financial ties to the manufacturers because it cannot find enough experts without financial ties to drug companies.

In an editorial, the journal's editors say the change means its readership will be better and more promptly informed about drugs that are just coming on the market and have been studied only in trials funded by industry. Editors concede there is a risk that the objectivity of authors may be compromised, but say that otherwise doctors might have to rely on pharmaceutical companies for information about new treatments (New England Journal of Medicine 2002;346:1901-2)[Full Text].

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