The DOI matches its Crossref record; 77 of the 81 references it cites were found in a registry or an index.
Pharmaceutical industry sponsorship and research outcome and quality: systematic review
Open accessAbstract
OBJECTIVE: To investigate whether funding of drug studies by the pharmaceutical industry is associated with outcomes that are favourable to the funder and whether the methods of trials funded by pharmaceutical companies differ from the methods in trials with other sources of support. METHODS: Medline (January 1966 to December 2002) and Embase (January 1980 to December 2002) searches were supplemented with material identified in the references and in the authors' personal files. Data were independently abstracted by three of the authors and disagreements were resolved by consensus. RESULTS: 30 studies were included. Research funded by drug companies was less likely to be published than research funded by other sources. Studies sponsored by pharmaceutical companies were more likely to have outcomes favouring the sponsor than were studies with other sponsors (odds ratio 4.05; 95% confidence interval 2.98 to 5.51; 18 comparisons). None of the 13 studies that analysed methods reported that studies funded by industry was of poorer quality. CONCLUSION: Systematic bias favours products which are made by the company funding the research. Explanations include the selection of an inappropriate comparator to the product being investigated and publication bias.
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“pharmaceutical companies, who fund a substantial number of RCTs, are more likely to seek publication of results with statistically positive outcomes. 9”
From Reporting research results: a moral obligation for all researchers. (2007) · cites this paper as [9]
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“Several investigations show strong associations between the source of funding and the conclusions of research articles [ 219 – 222 ].”
From Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration (2007) · cites this paper as [222]
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“For example, bias, as indicated by a prevalence of more favourable outcomes, has been demonstrated for clinical research funded by industry compared with studies funded by other sources [257–259].”
From Reporting animal research: Explanation and elaboration for the ARRIVE guidelines 2.0 (2020) · cites this paper as [259]
In the citing paper
“Additionally, different outcomes from the same trials can be a source of pharmaceutical marketing bias.35”
In the citing paper
“Empirical evidence points toward funding source sometimes being associated with estimated treatment effects [30].”
From CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials (2010) · cites this paper as [30]
In the citing paper
“Lexchin and colleagues [166] observed that outcomes of reports of randomized trials and meta-analyses of clinical trials funded by the pharmaceutical industry are more likely to favor the sponsor's product compared to studies with other sources of funding.”
From The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration (2009) · cites this paper as [166]
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“ing number of clinical trials funded by industry overall in the current research environment.(35) Findings from a meta-analysis of trials comparing studies that were industry-sponsored with those that were otherwise funded showed that research funded by pharmaceutical companies was less likely to be published and was…”
BackgroundResultNeuraminidase inhibitors for preventing and treating influenza in healthy adults and children
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“Empirical evidence points toward funding source sometimes being associated with estimated treatment effects (30).”
BackgroundSertraline versus other antidepressive agents for depression
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BackgroundCritical health literacy: A review and critical analysis
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BackgroundHeres, S., Davis, J. M., Maino, K., Jetzinger, E., Kissling, W., & Leucht, S. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.2.185 · Cited by 451
Jørgensen, A. W., Hilden, J., & Gøtzsche, P. C. (2006) · BMJ · doi:10.1136/bmj.38973.444699.0b · Cited by 439
Margulis, A. V., Pladevall, M., Riera‐Guàrdia, N., Varas‐Lorenzo, C., Hazell, L., Berkman, N. D., Viswanathan, M., & Perez‐Gutthann, S. (2014) · Clinical Epidemiology · doi:10.2147/clep.s66677 · Cited by 455
“37 Although it has been noted that industry-sponsored studies are sometimes biased toward the product manufactured by the sponsor, 39–43 there are voices favoring 44 but also opposing 45 the addition of such a question into the Cochrane risk of bias tool.”
Woodruff, T. J., & Sutton, P. (2014) · Environmental Health Perspectives · doi:10.1289/ehp.1307175 · Cited by 427
Therapeutic Effects of Hyaluronic Acid on Osteoarthritis of the Knee
Wang, C., Lin, J., Chang, C., Lin, Y., & Hou, S. (2004) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-200403000-00012 · Cited by 430
Grunze, H., Vieta, E., Goodwin, G. M., Bowden, C. L., Licht, R. W., Möller, H., Kasper, S. F., & on behalf of the WFSBP Task Force on Treatment Guidelines for Bipolar Disorders (2013) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2013.770551 · Cited by 429
“Another methodological limitation is sponsor bias (Lexchin et al 2003;Perlis et al 2005;Lexchin and Light 2006;Heres et al 2006) inherent in most single studies on which the guidelines are based.”
BackgroundFostering integrity in research: Definitions, current knowledge, and future directions
Steneck, N. H. (2006) · Science and Engineering Ethics · doi:10.1007/pl00022268 · Cited by 407
Grunze, H., Vieta, E., Goodwin, G. M., Bowden, C., Licht, R. W., Möller, H.-J., Kasper, S., & WFSBP Task Force On Treatment Guidelines For Bipolar Disorders (2010) · The World Journal of Biological Psychiatry · doi:10.3109/15622970903555881 · Cited by 399
“Another methodological limitation is sponsor bias (Lexchin et al. 2003; Perlis et al. 2005; Heres et al. 2006; Lexchin and Light 2006) inherent in many single studies on which the guidelines are based.”
BackgroundTrial Publication after Registration in ClinicalTrials.Gov: A Cross-Sectional Analysis
Ross, J. S., Mulvey, G. K., Hines, E. M., Nissen, S. E., & Krumholz, H. M. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000144 · Cited by 401
“However, we also found significantly different publication rates among study types and primary sponsors, consistent with prior research [11].”
ResultNon-steroidal anti-inflammatory drugs for chronic low back pain
Enthoven, W. T. M., Roelofs, P. D. D. M., Deyo, R. A., van Tulder, M. W., & Koes, B. W. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012087 · Cited by 427
Tricco, A. C., Chit, A., Soobiah, C., Hallett, D. C., Meier, G., Chen, M. H., Tashkandi, M. F., Bauch, C. T., & Loeb, M. B. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-153 · Cited by 399
“For the other sources of bias criterion, industry-funded RCTs were scored as ‘unclear’, due to the potential for funding bias [17].”
BackgroundNeuraminidase inhibitors for preventing and treating influenza in adults and children
Jefferson, T., Jones, M. A., Doshi, P., Del Mar, C. B., Hama, R., Thompson, M. J., Spencer, E. A., Onakpoya, I. J., Mahtani, K. R., Nunan, D., et al. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008965.pub4 · Cited by 382
Bias in published cost effectiveness studies: systematic review
Bell, C. M., Urbach, D. R., Ray, J. G., Bayoumi, A. M., Rosen, A. B., Greenberg, D., & Neumann, P. J. (2006) · BMJ · doi:10.1136/bmj.38737.607558.80 · Cited by 383
Long-term pharmacotherapy for obesity and overweight
Padwal, R. S., Rucker, D., Li, S. K., Curioni, C., & Lau, D. C. (2003) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004094.pub2 · Cited by 384
Powered versus manual toothbrushing for oral health
Yaacob, M., Worthington, H. V., Deacon, S. A., Deery, C., Walmsley, A. D., Robinson, P. G., & Glenny, A.-M. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002281.pub3 · Cited by 374
Zhou, X., Teng, T., Zhang, Y., Del Giovane, C., Furukawa, T. A., Weisz, J. R., Li, X., Cuijpers, P., Coghill, D., Xiang, Y., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30137-1 · Cited by 367
Meta-assessment of bias in science
Fanelli, D., Costas, R., & Ioannidis, J. P. A. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1618569114 · Cited by 364
“Industry bias: Industry sponsorship may affect the direction and magnitude of effects reported by biomedical studies (21).”
BackgroundOutcome Reporting in Industry-Sponsored Trials of Gabapentin for Off-Label Use
Vedula, S. S., Bero, L. A., Scherer, R. W., & Dickersin, K. (2009) · New England Journal of Medicine · doi:10.1056/nejmsa0906126 · Cited by 360
Self-citationGrunze, H., Vieta, E., Goodwin, G. M., Bowden, C. L., Licht, R. W., Möller, H., Kasper, S. F., & WFSBP Task Force on Treatment Guide (2009) · The World Journal of Biological Psychiatry · doi:10.1080/15622970902823202 · Cited by 349
“Another methodological limitation is sponsor bias (Lexchin et al. 2003; Perlis et al. 2005; Heres et al. 2006; Lexchin and Light 2006) inherent in most single studies on which the guidelines are based.”
BackgroundAlpha-glucosidase inhibitors for type 2 diabetes mellitus
Van de Laar, F. A., Lucassen, P. L., Akkermans, R. P., Van de Lisdonk, E. H., Rutten, G. E., & Van Weel, C. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003639.pub2 · Cited by 335
The efficacy and safety of exogenous melatonin for primary sleep disorders a meta-analysis
Buscemi, N., Vandermeer, B., Hooton, N., Pandya, R., Tjosvold, L., Hartling, L., Baker, G., Klassen, T. P., & Vohra, S. (2005) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2005.0243.x · Cited by 399
“Moreover, in light of the potential relationship between study results and funding sources, it is somewhat reassuring that the majority of studies that reported funding source used public, rather than industry, funding.(38,39) However, it should be noted that half of the studies reviewed did not report funding source.”
ResultCataldo, J. K., Prochaska, J. J., & Glantz, S. A. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-1240 · Cited by 356
“This has been true for sponsorship not only from the tobacco industry [30,31] but also from the pharmaceutical [32,33] and chemical industries [34].”
Outcome Reporting Among Drug Trials Registered in ClinicalTrials.gov
Bourgeois, F. T., Murthy, S., & Mandl, K. D. (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-153-3-201008030-00006 · Cited by 332
“Systematic reviews of the literature have shown that industryfunded trials are more than 4 times more likely to report findings supporting their product than are trials without financial interests (34).”
Safety evaluation of topical applications of ethanol on the skin and inside the oral cavity
Lachenmeier, D. W. (2008) · Journal of Occupational Medicine and Toxicology · doi:10.1186/1745-6673-3-26 · Cited by 342
Boswood, A., Häggström, J. U., Gordon, S. G., Wess, G., Stepien, R. L., Oyama, M. A., Keene, B. W., Bonagura, J. D., MacDonald, K. A., Patteson, M. W., et al. (2016) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.14586 · Cited by 329
“Potential explanations of the increased likelihood of industry-sponsored research having positive findings include the following: Industrial sponsors might be more likely to support studies that are likely to succeed, industrial sponsors might design studies with an inappropriate comparator group, or there might be pu…”
BackgroundRising, K., Bacchetti, P., & Bero, L. (2008) · PLoS Medicine · doi:10.1371/journal.pmed.0050217 · Cited by 328
“We collected data on characteristics of randomized controlled trials that could influence bias including randomization [20,21], double blinding [21,22], choice of drug comparator [23–26], peer-review status of the publication [27], funding source [28,29], and financial ties of investigators [29,30] because these are c…”
MethodSelf-citationWhat’s in a p? Reassessing best practices for conducting and reporting hypothesis-testing research
Meyer, K. E., van Witteloostuijn, A. C., & Beugelsdijk, S. (2017) · Journal of International Business Studies · doi:10.1057/s41267-017-0078-8 · Cited by 323
Sertraline versus other antidepressive agents for depression
Cipriani, A., Ferla, T. L., Furukawa, T. A., Signoretti, A., Nakagawa, A., Churchill, R. C., McGuire, H., & Barbui, C. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006117.pub2 · Cited by 323
Combined oral contraceptive pills for treatment of acne
Arowojolu, A. O., Gallo, M. F., Lopez, L. M., & Grimes, D. A. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004425.pub6 · Cited by 318
Citalopram versus other anti-depressive agents for depression
Cipriani, A., Purgato, M., Furukawa, T. A., Trespidi, C., Imperadore, G., Signoretti, A., Churchill, R. C., Watanabe, N., & Barbui, C. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006534.pub2 · Cited by 314
Reproducible Research Practices and Transparency across the Biomedical Literature
Iqbal, S. A., Wallach, J. D., Khoury, M. J., Schully, S. D., & Ioannidis, J. P. A. (2016) · PLOS Biology · doi:10.1371/journal.pbio.1002333 · Cited by 310
Perlis, R. H., Perlis, C. S., Wu, Y., Hwang, C., Joseph, M., & Nierenberg, A. A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.10.1957 · Cited by 318
Pharmaceutical company funding and its consequences: A qualitative systematic review
Sismondo, S. (2007) · Contemporary Clinical Trials · doi:10.1016/j.cct.2007.08.001 · Cited by 304
“performed a similar systematic review, of the quantitative analyses of the relationships between research funding and outcomes, methodology, or publication; this review was broader in dates (1966–2002) and in languages of publication [4].”
MethodNewer generation antidepressants for depressive disorders in children and adolescents
Hetrick, S. E., McKenzie, J. E., Cox, G. R., Simmons, M. B., & Merry, S. N. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004851.pub3 · Cited by 291
Evidence-based medicine has been hijacked: a report to David Sackett
Ioannidis, J. P. A. (2016) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2016.02.012 · Cited by 305
“[16] Lexchin J, Bero LA, Djulbegovic B, Clark O.”
BackgroundScreening for Depression in Adult Patients in Primary Care Settings: A Systematic Evidence Review
O’Connor, E., Whitlock, E. P., Beil, T. L., & Gaynes, B. N. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-11-200912010-00007 · Cited by 279
“This evidence may not be generalizable to primary care because of recruitment of motivated patients, exclusion of patients with the most severe depression or suicidal patients, high withdrawal rates (81), and sponsorship by the drug industry (which has been shown to be more likely to demonstrate positive effects than…”
Background
Metadata
- Authors
- Lexchin, J., Bero, L. A., Djulbegovic, B., & Clark, O.
- Affiliations
- York University (CA)
- University of California, San Francisco (US)
- Corresponding author
- Lexchin, Joel
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2003-05-29
- Volume
- 326
- Issue
- 7400
- Pages
- 1167-1170
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC156458
- OpenAlex
- W2136284733
- Cited by
- 2,147
- References
- 81
- Citations by year
- 2026: 34 · 2025: 49 · 2024: 61 · 2023: 56 · 2022: 57 · 2021: 53 · 2020: 89 · 2019: 74 · 2018: 86 · 2017: 84 · 2016: 82 · 2015: 100 · 2014: 114 · 2013: 107 · 2012: 150
- FWCI
- 10.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Nursing › Issues, ethics and legal aspects › Pharmaceutical industry and healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Keywords
- pharmaceutical industry sponsorship, research bias, publication bias, trial quality, research funding sources, comparator selection, conflicts of interest
- MeSH terms
- Clinical Trials as Topic, Drug Industry, Financing, Organized, Publishing, Research, Research Support as Topic
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