Physicians, patients, and research participants believe researchers’ financial ties to industry decrease the quality of research evidence, and patients believe that financial ties influence professional behavior and should be disclosed, a review of studies looking at views on financial ties to pharmaceutical and medical device companies found.
For some patients, knowledge of the researchers’ financial ties to industry would affect their willingness to participate in research studies, Dr. Cary Gross of Yale University, New Haven, Conn., and his colleagues wrote in the Apr. 26 issue of Archives of Internal Medicine.
“When any financial tie was disclosed, there was a reduction in the perceived quality of research among research participants and physicians,” they reported.
They noted that in clinical care, patients believed that financial ties also decreased the quality of care and affected prescribing behavior.
The investigators reviewed 11 original quantitative studies of patients’, research participants’, and journal readers’ views about financial ties and perceptions of quality.
In studies considering patient perception of cost, a range of 26%-76% said they believed that gifts to physicians increase the cost of care, although fewer patients thought professional gifts were a problem.
“For instance, in a 2009 study of 903 patients contacted by telephone, 9% disapproved of physicians receiving free drug samples and 16% disapproved of free medical texts, compared with disapproval rates of 55% and 68%, respectively, for paid dinners and golf tournaments,” Dr. Gross and his colleagues wrote (Arch. Intern. Med. 2010;170:675-82).
In other studies, when respondents were asked to rate study disclosure statements, they deemed researchers with financial tie statements to be less trustworthy and less important than those who did not have them, they noted.
For some potential trial participants, disclosure of financial ties affected their willingness to participate. “Three studies reported that prospective research participants were least willing to participate in a hypothetical clinical trial when a researcher equity ownership was disclosed,” according to Dr. Gross and his colleagues. “Of note, the participants also reported less trust in researchers after disclosure of financial ties.”
The literature review “suggests that a sizeable portion of the public wants to know about physician financial ties,” and that patients and research participants can distinguish between different types of financial ties and determine the relative importance of disclosure of each, the investigators concluded.
In an accompanying editorial, Eric Campbell, Ph.D., of Harvard University, Boston, noted that patients and research participants want access to data on conflicts of interest to make decisions about the potential impacts of industry relationships on the care they receive (Arch. Intern. Med. 2010;170:667).
“For example, they want to be able to ascertain if, and to what extent, their prescriptions could be inappropriately influenced by the financial relationships between their physician and pharmaceutical companies,” Dr. Campbell wrote.
However, collecting and presenting industry data in a useful way will not be easy, and “for consumers to use the data, it is clear that the quality of the data that is reported by companies must be improved,” he said.
Public disclosure seems like a likely first step toward a more active government and health care institution role in evaluating and managing physician-industry relationships, Dr. Campbell wrote. “This will likely be seen by some physicians as a direct assault on their sense of professional identity and autonomy.”
However, “this transparency will help prevent the further erosion of public trust in the medical profession,” he argued.
The literature review was supported in part by a Doris Duke Clinical Research Fellowship. Dr. Gross disclosed having served as an expert witness, and another author disclosed serving as a paid data and safety committee member for Genzyme Corp. Dr. Campbell did not report any financial disclosures.