New Cochrane policy tightens limits on industry funding
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《英国医生杂志》
New York
A year long struggle over funding of the Cochrane Collaboration has been settled: a policy just issued by the organisation will limit industry funding.
The collaboration is an international organisation that reviews health interventions and disseminates the information worldwide. James Neilson, who co-chairs the collaboration's steering group, said the policy reflects the overwhelming consensus of members that they want a "clear separation between production of reviews and commercial sponsorship."
Some Cochrane members opposed the move, saying the restrictions would threaten the financial viability of certain elements of the work of the Cochrane Collaboration which are currently sponsored by industry.
"We're not sure about the impact," said Dr Neilson. "We decided it was important to start by establishing the principle first, rather than finding out what the impact would be. The next step will be to find out what the implications will be. There are some entities that will find themselves in some difficulty. But that's why there is a transition period to allow them to seek alternate sources of funding."
Contradictory interpretations of previous Cochrane policy came to light when it was shown that a drug company that had a stake in a review provided funding for the review ( BMJ 2003;327: 924). After complaints from some members the organisation launched a worldwide consultation, eliciting responses from 156 organisations and individuals.
The statement crafted after the consultation period "makes a much clearer policy than we've had hitherto," said Dr Neilson, who said the policy addresses the "reality and perception" of bias. The new policy specifically prohibits funding of Cochrane reviews or review groups by "commercial sources with financial interests in the conclusions of Cochrane reviews."
However, a consensus was not reached on funding of Cochrane centres, and further evaluation of this issue continues. Other changes include the creation of a "funding arbiter." The arbiter will oversee management of difficult cases. The policy calls on collaborative review groups to refer existing reviews that would not be eligible under the new rules to the funding arbiter for review. Ineligible reviews could be withdrawn from the Cochrane Library.
The former consumer advocate for the Cochrane Collaboration, Hilda Bastian, said the new policy takes the public interest "very seriously." She added, "It's great to see that the collaboration is going to hold firmly to trying to be an independent reviewer of research."
Ms Bastian expressed concern, however, about section 15 of the policy, which allows employees of manufacturers of drugs or medical devices to be on a review panel or to propose a review. "That seems strange to me—an independent researcher can't get their salary from a company, but an actual employee can be an author."
Dr Neilson acknowledged that section 15 had received some comment since publication of the new policy. "There will be a number of unusual things that will crop up. That is why we established the position of funding arbiter," he said.
Ms Bastian cautions: "While there has been much finger pointing at the pharmaceutical industry, it is important not to let the public sector off the hook for failing to fund public interest efforts."
Facing a potential loss of funding to the collaboration, Dr Neilson said, "I'd completely agree with Ms Bastian."(Jeanne Lenzer)
A year long struggle over funding of the Cochrane Collaboration has been settled: a policy just issued by the organisation will limit industry funding.
The collaboration is an international organisation that reviews health interventions and disseminates the information worldwide. James Neilson, who co-chairs the collaboration's steering group, said the policy reflects the overwhelming consensus of members that they want a "clear separation between production of reviews and commercial sponsorship."
Some Cochrane members opposed the move, saying the restrictions would threaten the financial viability of certain elements of the work of the Cochrane Collaboration which are currently sponsored by industry.
"We're not sure about the impact," said Dr Neilson. "We decided it was important to start by establishing the principle first, rather than finding out what the impact would be. The next step will be to find out what the implications will be. There are some entities that will find themselves in some difficulty. But that's why there is a transition period to allow them to seek alternate sources of funding."
Contradictory interpretations of previous Cochrane policy came to light when it was shown that a drug company that had a stake in a review provided funding for the review ( BMJ 2003;327: 924). After complaints from some members the organisation launched a worldwide consultation, eliciting responses from 156 organisations and individuals.
The statement crafted after the consultation period "makes a much clearer policy than we've had hitherto," said Dr Neilson, who said the policy addresses the "reality and perception" of bias. The new policy specifically prohibits funding of Cochrane reviews or review groups by "commercial sources with financial interests in the conclusions of Cochrane reviews."
However, a consensus was not reached on funding of Cochrane centres, and further evaluation of this issue continues. Other changes include the creation of a "funding arbiter." The arbiter will oversee management of difficult cases. The policy calls on collaborative review groups to refer existing reviews that would not be eligible under the new rules to the funding arbiter for review. Ineligible reviews could be withdrawn from the Cochrane Library.
The former consumer advocate for the Cochrane Collaboration, Hilda Bastian, said the new policy takes the public interest "very seriously." She added, "It's great to see that the collaboration is going to hold firmly to trying to be an independent reviewer of research."
Ms Bastian expressed concern, however, about section 15 of the policy, which allows employees of manufacturers of drugs or medical devices to be on a review panel or to propose a review. "That seems strange to me—an independent researcher can't get their salary from a company, but an actual employee can be an author."
Dr Neilson acknowledged that section 15 had received some comment since publication of the new policy. "There will be a number of unusual things that will crop up. That is why we established the position of funding arbiter," he said.
Ms Bastian cautions: "While there has been much finger pointing at the pharmaceutical industry, it is important not to let the public sector off the hook for failing to fund public interest efforts."
Facing a potential loss of funding to the collaboration, Dr Neilson said, "I'd completely agree with Ms Bastian."(Jeanne Lenzer)