In a recent disclosure, research published in the Journal of the American Medical Association (JAMA) revealed that major pharmaceutical companies paid $1.06 billion to peer reviewers working with top medical journals between 2020 and 2022. The analysis, which scrutinized payments to reviewers affiliated with The BMJ, JAMA, The Lancet, and The New England Journal of Medicine, found that $1 billion of these funds went toward research grants for the reviewers or their institutions. An additional $64.18 million covered general payments, including travel and meals, with consulting fees and speaker compensation making up a significant portion at $34.31 million and $11.80 million, respectively.
Of the nearly 2,000 physician reviewers examined, over half had received at least one payment from the pharmaceutical industry within the two-year period. The study’s authors expressed concerns about how these financial ties could influence the integrity of scientific research, noting that conflicts of interest in the peer-review process have been historically difficult to address.
Peer reviewers play an essential, albeit traditionally hidden, role in validating research for publication.
Yet, unlike the strict conflict-of-interest disclosures required from authors, the guidelines for peer reviewers remain opaque and often do not mandate public transparency about industry affiliations. According to the study’s authors, while journal editors may ask reviewers to disclose conflicts, this information is rarely shared with the public—a critical issue given that many high-profile reviewers may have connections to pharmaceutical companies due to their specialized expertise.
Dr. Karl Jablonowski, a senior research scientist with Children’s Health Defense, voiced concerns over potential biases, stating that when reviewers have financial connections with pharmaceutical giants, it jeopardizes the objectivity essential to scientific advancement.
“The peer review process should remain free of any financial conflicts to preserve its value as a forum for scientific rigor and community exchange,” he said.
Additional concerns were raised by Dr. Adriane Fugh-Berman, the director of PharmedOut, a Georgetown University Medical Center project focused on industry influence in healthcare. She highlighted how the pharmaceutical industry’s influence extends beyond direct payments, as companies are substantial purchasers of preprint articles and advertisers in journals. This, she said, inevitably affects which articles get published, especially those critical of pharmaceutical practices.
The researchers based their analysis on the 2022 reviewer lists from the journals and matched this information with data from the Centers for Medicare & Medicaid Services Open Payments database. Established in 2013, the database requires pharmaceutical companies to report payments to physicians, aiming to increase public transparency. The study limited its sample to U.S.-based physicians, the only group listed on Open Payments, yielding a sample of 1,962 practicing physicians who served as reviewers, 145 of whom reviewed for multiple journals.
In total, 1,155 reviewers received industry payments between 2020 and 2022. While many funds were directed toward research, over half of the reviewers accepted additional payments for services such as travel, speaking engagements, and consulting. The median value of these direct payments was approximately $7,614. Importantly, the study’s authors suggest that their findings may represent a conservative estimate, as non-U.S. physicians and non-practicing reviewers were excluded, along with payments from other potential sources of conflict, such as technology or insurance companies.
In light of these findings, the study authors called for greater transparency and further research to better understand the implications of industry payments on the peer-review process in academic publishing.
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