Drug companies urged to make research available to health workers in poorer countries

Anne Gulland
Research should be made available to doctors and health workers  in low and middle income countries - © 2018 Simon Townsley Ltd

Pharmaceutical companies are being urged to ensure that the clinical studies they fund are made openly and freely available to allow scientists and doctors in developing countries to access the latest scientific research.

The drug industry funds approximately half of all biomedical research, however much of that work is locked behind paywalls on scientific publishers’ websites.

Only people who pay a one-off charge of around £25 or buy an expensive journal subscription of about £350 a year can access the findings – and this is often beyond the reach of doctors and scientists in developing countries. 

Open Pharma, a coalition of researchers and pharmaceutical industry executives, said that open access ensures that the “the highest quality, peer-reviewed evidence is available to anyone who needs it anywhere in the world. Publishing with open access improves transparency, advances medical science and, we believe, ultimately improves patient care”.

Chris Winchester of Open Pharma said: “So far, organisations such as the Bill and Melinda Gates Foundation and the Wellcome Trust have led the debate about free access to the results of vital medical research. 

“Such access informs future work aimed at developing new, better and safer treatments for patients or to prevent disease. We feel it is time that the industry, which funds half that work, joined that conversation.”

Half of biomedical research is locked behind publishing companies' paywalls Credit: Samyukta Lakshmi/Bloomberg

Public bodies such as the UK research councils, the Department for International Development and charities usually mandate that any research they fund is published openly from the date of publication.

But industry funders do not impose the same restrictions, allowing authors to choose their publications.

Just two UK pharmaceutical companies – Shire and Ipsen – have mandated open access to those they fund. 

Richard Smith, the former editor of the BMJ and a supporter of open access, said that one reason pharmaceutical companies do not routinely demand it is that they might be seen as promoting products directly to patients – although he said this worry was misplaced.

He added that pharmaceutical companies were also worried about rocking the boat.

“There are an increasing number of open access journals but some of the most prestigious – such as the New England Journal of Medicine – have held out. For some of the pharmaceutical companies to say to researchers they have to publish open access it makes them nervous.

“The narrative always tends to be that pharmaceutical companies are the bad guys – if they do something people are immediately suspicious and that makes them risk averse,” he said.

Dr Smith, now chair of the board of trustees at the International Centre for Diarrhoeal Disease Research in Bangladesh, said researchers in low income countries could get access to research via a World Health Organization site called Hinari but authors needed good internet connection to get online.

And this is not available to people in middle income countries who have been “starved” of new research, he said.

“This is true of clinicians too - because there hasn’t been easy access to research there’s no culture of reading, studying or critiquing so people carry on doing what they have always done or are easy prey to pharmaceutical company reps,” he said. 

There are two open access options available to researchers and funders: “green”, where authors are allowed to publish their findings on their own or their institution’s website once it has been published in a journal; or “gold” where they or their funders bear the cost of publication, paying an “article processing charge” – somewhere between £1,500 and £3,000. The article is made freely available online but this route also enables publishers to remain financially viable.

Professor Mike Clarke, an expert in research methodology from Queen’s University Belfast, said the cost of publication for pharmaceutical companies was negligible.

“Pharmaceutical firms may be paying £1m to £2m for a study so they can spare £1,500 for a publication fee.

“Pharma firms should be showing that they have nothing to hide and that they value the fact there are no barriers to accessing their studies,” he said.

Prof Clarke added that some people had urged pharmaceutical firms and authors to self publish but he rejected this.

“Putting research in a journal means other experts have looked at it and journal editors have looked at it. It carries a stamp of approval,” he said. 

But the rise of the “author pays” model has also meant that researchers in low and middle income countries find it difficult to get their research published.

Prof Clarke said that publishers need to come up with some true open access options where it was both free to publish and read the article.

“But this is only sustainable if you have someone with very deep pockets to fund it,” he said. 

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