Mapping conflict of interests: scoping review
Open accessAbstract
OBJECTIVE: To identify all known ties between the medical product industry and the healthcare ecosystem. DESIGN: Scoping review. METHODS: From initial literature searches and expert input, a map was created to show the network of medical product industry ties across parties and activities in the healthcare ecosystem. Through a scoping review, the ties were then verified, cataloged, and characterized, with data abstracted on types of industry ties (financial, non-financial), applicable policies for conflict of interests, and publicly available data sources. MAIN OUTCOME MEASURES: Presence and types of medical product industry ties to activities and parties, presence of policies for conflict of interests, and publicly available data. RESULTS: A map derived through synthesis of 538 articles from 37 countries shows an extensive network of medical product industry ties to activities and parties in the healthcare ecosystem. Key activities include research, healthcare education, guideline development, formulary selection, and clinical care. Parties include non-profit entities, the healthcare profession, the market supply chain, and government. The medical product industry has direct ties to all parties and some activities through multiple pathways; direct ties extend through interrelationships among parties and activities. The most frequently identified parties were within the healthcare profession, with individual professionals described in 422 (78%) of the included studies. More than half (303, 56%) of the publications documented medical product industry ties to research, with clinical care (156, 29%), health professional education (145, 27%), guideline development (33, 6%), and formulary selection (8, 1%) appearing less often. Policies for conflict of interests exist for some financial and a few non-financial ties; publicly available data sources seldom describe or quantify these ties. CONCLUSIONS: An extensive network of medical product industry ties to activities and parties exists in the healthcare ecosystem. Policies for conflict of interests and publicly available data are lacking, suggesting that enhanced oversight and transparency are needed to protect patient care from commercial influence and to ensure public trust.
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Each individual player may have multiple financial and non-financial interactions with multiple entities, often in ways consistent with the primary interests of benefiting people with lived experience and society.
“In this ecosystem, not only clinicians and researchers, but each individual player may have multiple financial and nonfinancial interactions with multiple entities 269 , often in ways that are consistent with the primary interests of benefitting PWLE and society.”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [269]
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- Authors
- Chimonas, S., Mamoor, M., Zimbalist, S. A., Barrow, B., Bach, P. B., & Korenstein, D.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Brown University (US)
- Corresponding author
- Chimonas, Susan
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2021-11-03
- Volume
- 375
- Pages
- e066576
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC8565086
- OpenAlex
- W3209153473
- Cited by
- 54
- References
- 63
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 16 · 2023: 7 · 2022: 9 · 2021: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BMJ (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Arnold Ventures
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Social Sciences › Business, Management and Accounting › Strategy and Management › Political Influence and Corporate Strategies
- Keywords
- conflicts of interest, pharmaceutical industry, healthcare ecosystem, industry ties, financial conflicts of interest, non-financial conflicts of interest, conflict of interest policies, transparency, research funding, health professions education, guideline development, formulary selection, clinical care, public trust
- MeSH terms
- Drug Industry, Health Policy, Humans, Maps as Topic, Global Health, Conflict of Interest, Health Care Sector
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