A new study that quantifies industry financial conflicts of interest (FCOIs) found that nearly nine out of 10 physicians and researchers who helped develop the National Comprehensive Network (NCCN) guidelines—work that influences practices and defines drugs reimbursable by Medicare—reported financial ties to the pharmaceutical and medical device industries. The findings were reported online in JAMA Oncology.
Researchers from the University of North Carolina Lineberger Comprehensive Cancer Center conducted a cross-sectional analysis of Open Payments data to assess FCOIs during 2014 among 125 authors of guidelines for four cancers with the highest incidence in the United States, including breast, colon, prostate, and lung cancer. The investigators used the Open Payments database for FCOIs because the data is publicly reported by the Centers for Medicare & Medicaid Services.
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A total of $30,287,549 in research payments were paid to guideline authors in 2014, compared with $1,251,422 in general payments. Of the 125 guideline authors, 108 (86%) had at least one reported FCOI, including 84% who accepted general payments (eg, fees for consulting, meals, or lodging) and 47% who accepted research payments (eg, fees for clinical trials). Guideline authors received a mean $10,011 in general payments, with the majority (56%) receiving a $1000 or more. For research payments, guideline authors received an average of $236,066. The data also identified 8 guideline authors (6%) whose FCOIs exceeded the $50,000 net and/or $20,000 single-company maximum stipulated by the NCCN guideline policy.
The researcher cited one study limitation in that Open Payments collects data only on physicians so FICOs of nonphysician NCCN guideline authors were not available.
The findings underscore the potential for undue influence of industry in oncology clinical practice guidelines that need to be addressed in future research. “More research is needed to determine which kinds of relationships are more likely to produce the unwanted consequence of physician bias to create rational, evidence-based policies that allow for the participation of key clinical experts while managing real or perceived conflicts,” concluded the researchers.
