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Mark Friedberg, BA; Bernard Saffran, PhD; Tammy J. Stinson, MS; Wendy Nelson, PhD; Charles L. Bennett, MD, PhD

JAMA. 1999;282:1453-1457.

Context  Recent studies have found that when investigators have financial relationships with pharmaceutical or product manufacturers, they are less likely to criticize the safety or efficacy of these agents. The effects of health economics research on pharmaceutical company revenue make drug investigations potentially vulnerable to this bias.

Objective  To determine whether there is an association between pharmaceutical industry sponsorship and economic assessment of oncology drugs.

Design  MEDLINE and HealthSTAR databases (1988-1998) were searched for original English-language research articles of cost or cost-effectiveness analyses of 6 oncology drugs in 3 new drug categories (hematopoietic colony-stimulating factors, serotonin antagonist antiemetics, and taxanes), yielding 44 eligible articles. Two investigators independently abstracted each article based on specific criteria.

Main Outcome Measure  Relationships between funding source and (1) qualitative cost assessment (favorable, neutral, or unfavorable) and (2) qualitative conclusions that overstated quantitative results.

Results  Pharmaceutical company–sponsored studies were less likely than nonprofit-sponsored studies to report unfavorable qualitative conclusions (1/20 [5%] vs 9/24 [38%]; P=.04), whereas overstatements of quantitative results were not significantly different in pharmaceutical company–sponsored (6/20 [30%]) vs nonprofit-sponsored (3/24 [13%]) studies (P=.26).

Conclusions  Although we did not identify bias in individual studies, these findings indicate that pharmaceutical company sponsorship of economic analyses is associated with reduced likelihood of reporting unfavorable results.

Author Affiliations: Institute for Health Services Research and Policy Studies (Dr Bennett) and Division of Hematology/Oncology, Northwestern University (Mr Friedberg and Drs Nelson and Bennett) and Lakeside Veterans Affairs Medical Center (Ms Stinson and Dr Bennett), Chicago, Ill; and the Department of Economics, Swarthmore College, Swarthmore, Pa (Dr Saffran).

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