(Illustration: Margaret Shear, Public Library of Science)įortunately from the point of view of the companies funding these trials-but unfortunately for the credibility of the journals who publish them-these trials rarely produce results that are unfavourable to the companies' products.
The quality of the journal will bless the quality of the drug. The doctors receiving the reprints may not read them, but they will be impressed by the name of the journal from which they come.
For a drug company, a favourable trial is worth thousands of pages of advertising, which is why a company will sometimes spend upwards of a million dollars on reprints of the trial for worldwide distribution. A large trial published in a major journal has the journal's stamp of approval (unlike the advertising), will be distributed around the world, and may well receive global media coverage, particularly if promoted simultaneously by press releases from both the journal and the expensive public-relations firm hired by the pharmaceutical company that sponsored the trial. Far from discounting these, readers see randomised controlled trials as one of the highest forms of evidence.
The much bigger problem lies with the original studies, particularly the clinical trials, published by journals. Doctors may not be as uninfluenced by the advertisements as they would like to believe, but in every sphere, the public is used to discounting the claims of advertisers. The advertisements may often be misleading and the profits worth millions, but the advertisements are there for all to see and criticise. The most conspicuous example of medical journals' dependence on the pharmaceutical industry is the substantial income from advertising, but this is, I suggest, the least corrupting form of dependence.
The Problem: Less to Do with Advertising, More to Do with Sponsored Trials