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A recent study published in JAMA has uncovered a startling statistic: nearly half of U.S. physician peer reviewers for four major international medical journals received more than $1 billion (£765 million; €917 million) in industry payments over a three-year period. This significant financial relationship raises important questions about potential conflicts of interest in the peer review process.
The study examined the payments made to peer reviewers affiliated with The BMJ, JAMA, The Lancet, and the New England Journal of Medicine, using data from the U.S. Centers for Medicare and Medicaid Services’ open payment database. Between 2020 and 2022, researchers identified 1,962 U.S. doctors who served as peer reviewers, with 58.9% receiving at least one payment from the pharmaceutical or medical device industries. While most of the funds were directed toward the reviewers’ institutions, the sheer volume of financial ties highlights a significant concern regarding the integrity of the peer review process.
According to Christopher Wallis, the study’s corresponding author from the University of Toronto, “Peer reviewers act as critical arbiters of the validity and relevance of peer-reviewed studies. Therefore, understanding the potential intellectual and financial relations that may affect their decision-making is key to understanding how these influences affect peer-reviewed literature.”
The study found that the majority of reviewers (71.2%) were men, with male reviewers receiving nearly double the payments of their female counterparts—an average of $38,959 compared to $19,586. Most reviewers accepted general payments rather than research payments, which included funding for specific projects where the doctor served as the principal investigator.
Despite the established conflict of interest policies for journal authors and editors, few journals extend similar transparency requirements to peer reviewers. This lack of scrutiny creates a “traditionally opaque” environment, according to the researchers. While some journals, like The BMJ, advocate for transparency and require authors and reviewers to declare their interests, others are still grappling with how to implement effective measures.
In response to the study, Theo Bloom, executive editor of The BMJ, stated, “We believe scrutiny and transparency are necessary in this area… We take these approaches because we believe it is inevitable that sums such as the ones you describe are bound to influence the perspective of researchers when they are acting as peer reviewers.”
Similarly, a spokesperson for The Lancet Group emphasized that their editorial process requires reviewers to recuse themselves if they have relevant competing interests. JAMA also mandates that peer reviewers disclose any conflicts of interest and ensures that publication decisions are made solely by editors.
The study highlights the urgent need for further research and transparency regarding industry payments in the peer review system. The authors noted that it remains unclear whether these payments are relevant to the articles being reviewed or how the findings might apply to non-U.S. physicians.
As the dialogue surrounding conflicts of interest in academic publishing continues, the findings of this study serve as a catalyst for reevaluating the peer review process and enhancing transparency to uphold the integrity of scientific literature.
For further details, the study can be accessed in JAMA here.
