The giant Cochrane Collaboration marked its 10th anniversary at a conference in Barcelona in October by launching an international debate about whether to embrace sponsorship from private industry. Professor Jim Neilson, cochair of the steering group that runs the collaboration, told CMAJ that a global consultation process will start in December. “Members have made it very clear they want to have input into this decision.”
The collaboration, an international network of 10 000 researchers, produces up-to-date summaries about the value of therapies ranging from antidepressants to zinc supplements. They are based on systematic reviews (www.cochrane.org.), and until recently most were publicly funded. Now, some participants are exploring links with drug companies and other private-sector players with a vested interest in review outcomes. The issue is causing major conflicts within the global group.
At the opening plenary session, Dr. Peter Gøtzsche, director of the Nordic Cochrane Center, told more than 600 conference participants that drug company sponsorship would corrupt systematic reviews. “If this leads to less reviews, but more trustworthy reviews, it will be a worthwhile outcome.”
The Cochrane Collaboration already has a policy discouraging sponsorship from companies with a vested interest in a review's outcome, but this is increasingly being ignored because some within the organization consider industry money crucial to the collaboration's survival. Ironically, the session debating drug company sponsorship was sponsored by AstraZeneca. Although no vote was taken, on at least 3 occasions there was loud applause as speakers suggested prohibiting industry sponsorship.
Dr. Peter Tugwell of the University of Ottawa, a member of the Cochrane steering group, sees benefits in an alliance with the private sector, but adds: “It would be great if the Canadian government would fund us, so we wouldn't have to go to industry.” Asked to elaborate, he said government funding is preferred “because [there] seems to be a majority of individuals who feel more comfortable that way.” With over 600 Canadian researchers contributing to the work of the collaboration and demand for reviews growing, the national Cochrane centre is currently seeking new federal funding.
Dr. Gordon Guyatt of McMaster University, a key architect in the move toward evidence-based medicine, urged more federal funding for Canada's Cochrane efforts. He also suggested that industry funding could flow through an independent trust, ensuring no connection between donors and researchers. “That strikes me as the best compromise.”
Others, like former McMaster University researcher Dr. Andy Oxman, fear industry funding will cost the collaboration its reputation for independence. He says a false comparison is being made between private and public funding because a large share of drug company revenue flows from publicly subsidized health systems. “The problem is, private decisions are being made about how to spend public money.”
Neilson, a professor at the University of Liverpool, said the consultation process will be finalized next week, and a final decision about industry funding will be made by February. — Ray Moynihan, Barcelona