Australian Clinicans Not Declaring Conflicts of Interest For Pharma Funded Studies: Experts

Scientia Clinical Research Ltd lab in Randwick in Sydney, Australia on Nov. 5, 2020. (Pool/Getty Images)

Researchers from the University of Sydney have called for “more transparency” after their review revealed that nearly half of 120 pharmaceutical trials had missing or incomplete declarations of conflict of interest (COI).

“Disclosures are crucial to keeping research transparent,” said co-author Assoc. Prof. Barbara Mintzes from the University of Sydney.

Conflicts of interest in research refer to situations when the author’s judgement may be compromised or appear to be so due to financial or personal reasons.

Funding from pharmaceutical companies often require disclosure of conflict as “pharmaceutical industry funding is associated with a bias towards study results that are more favourable towards the tested product,” Mintzes said.

She said that the importance of full disclosure of pharmaceutical industry funding has long been recognised, and it was a requirement for authors to report on it.

Though a disclosure does not eliminate conflicts of interests such as biased reporting, Mintzes  said that “disclosing it allows readers to consider the possible impact on the research.”

The study found discrepancies in COI by examining pharmaceutical companies’ reports of their payments to health professionals–as listed publicly by Medicines Australia–and compared these with authors’ own declarations.

The team examined 120 randomised controlled trials for pharmaceuticals published from January to August 2020, consisting of 323 Australian authors in total and found 46.7 percent of the trials had missing or inaccurate COI declarations.

Randomised controlled trials (RCT) are experiments where participants are randomly assorted into the testing group that tests the drug or the control group that receives a placebo.

They are often used to test for the safety and efficacy of medical interventions as it allows researchers to examining the difference in outcomes between the testing and the control group.

Of the 120 RCTs examined in the Sydney study, there were 89 incomplete or missing declarations amongst 78 researchers from 56 studies.

Within the 89 discrepant declarations, 51.7 percent stated no competition of interests, and 43.8 percent gave incomplete statements.

A small minority of the studies omitted the company’s name or left out a section for COI entirely in the article making up 4.5 percent of the statements.

The median value of undisclosed payments reached $8,944 (US$6,543) with a range from $140 to $97,600 AUD (US$102–$71,394) for the highest and lowest values for undisclosed payments.

Companies listed on Medicines Australia need to declare payments to individual clinicians for consultancies, speaking, advisory boards and educational events. Though this has been a requirement since October 2015, underreports of COI still significant.

Mintzes said despite the significant findings of the study, the results “underestimate the true extent of underreporting of conflicts of interest in Australia.”

Currently, disclosure for COI for Medicines Australia is self-regulated, and not all types of payments require to be reported, with payments for food and drinks often excluded. Additionally, not all companies are members of Medicines Australia, and with only authors who are also health professionals listed publicly, this may explain how some underreported COIs go undetected.

The authors noted that Australia is not the only country witnessing similar issues with significant discrepancies found in Danish and US physician studies.

The discrepancies “highlight the need for more transparent and comprehensive COI reporting,” the authors concluded.

“Our study adds to the evidence that under-reporting of COI is likely widespread globally.”