It's been years since the major pharma companies agreed to participate in the Registry of All Trials, meaning that they'd end the practice of only reporting on trials whose outcomes they were pleased with, leaving about half of all trials unreported-on.
Today, Ben Goldacre (who is the Registry's most prominent advocate) and colleagues released a paper in the British Medical Journal reporting on their audit of pharmaceutical companies' record on keeping that promise.
What they found is pretty dismal: to put it bluntly, pharma companies are cheating like crazy.
The paper is accompanied by a website that will shortly publish a ranking showing which pharma companies are most honest in reporting in on their trials.
This is a vital scientific/health question: pharmaceutical companies have spent decades cherry-picking their studies, suppressing those that put their products in a bad light, only telling regulators about the successful ones. About half of all pharmaceutical trials were never reported in. If you were trialing a quarter to see if it always came up heads, and you got to suppress half of your results, you could prove that it was fair, that it was all-heads, or all-tails, or anything in between.
So what did we find? The results on the individual companies are important, but we also came across some fascinating patterns. While companies superficially have commitments to register and report clinical trials, in reality, there are often huge gaps in their policies, with many failing to include past trials (trials on the medicines we use today) and trials on off-label uses or unlicensed medicines, which are both important. We also found a huge range of commitments, which is exactly what audits are good for: identify who's doing well, and who's doing badly, so that everyone can learn from the best players. Lastly, as we went along we collected some fascinating examples of problematic policies, ambiguous language, inconsistent commitments, odd exclusions, and so on.
Overall this audit was a huge project, and we hope it will be widely used. You can see which companies are the best, and the worst. If you're a researcher trying to get information on a trial from a company, you can use this to determine whether a company are breaching their commitments. If you're an ethical investor (at the AllTrials campaign we have a network of dozens, covering €3.5t trillion of investments) you can use this to guide your activist investment choices. If you're a doctor, or a patient, you might use this as a benchmark for the trustworthiness of a company.
[Ben Goldacre, Kamal R Mahtani, Carl Heneghan, Igho Onakpoya, Ian Bushfield and Liam Smeeth,/BMJ]
How do the world's biggest drug companies compare, in their transparency commitments?
[Ben Goldacre/Bad Science]
(Image: ParentingPatch, CC-BY-SA)