Drug company-funded studies tend to favor more expensive drugs: report

The story at a glance

  • In a new review, researchers found that industry-sponsored reviews tended to favor more expensive drugs over those conducted by independent third parties, highlighting a systemic bias in these practices.

Cost-Effectiveness Analysis (CEA) studies can be useful both for patients when deciding which medicine to take and for insurance companies when deciding which medicines to include in their formularies.

While in theory CEAs appear to be an effective tool for increasing healthcare efficiency and affordability, a new study published in The BMJ revealed “significant, systemic and sponsorship bias” among CEAs conducted by drug manufacturers as opposed to independent third parties.

Researchers from Canadian and Chinese universities used data from the Tufts Cost-Effectiveness Analysis Registry to evaluate ACEs published between 1976 and 2021. All studies that included incremental cost-effectiveness ratios (ICERs) using age-adjusted life years based on quality were considered for inclusion.

Separating analyzes funded by industry (approximately 30%) from those that were not, the data showed that studies funded by drug manufacturers were more likely to publish ICERs below the $50,000 thresholds. , $100,000 and $150,000, compared to independent studies.

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In other words, industry-sponsored ACEs were more likely to report that their interventions were cost-effective than unsponsored studies.

Seventy percent of all published studies reported ICERs to be below $50,000 and only 20% found them above $100,000, “indicating publication bias against ACEs with unfavorable results based on commonly used profitability standards,” the authors wrote.

Based on this data, insurance companies may be more inclined to use independent studies as a guide when evaluating the cost-effectiveness of certain drugs, they said.

New drugs or devices can generate much higher profits when covered by insurance plans than those that aren’t, the researchers explained. However, this economic link between the industry and the approval of insurance coverage could lead to sponsorship bias.

CEAs can be conducted on medical devices, pharmaceuticals and other health interventions. But in the current study, drug ACEs made up the majority of industry-sponsored studies, with one of the strongest sponsorship biases seen in drug reviews.

Since wealthier countries have the resources and capacity to have independent parties conduct CEAs, other countries may need to rely on industry-sponsored published analyzes to make decisions about cover.

Taken in a broader context, these findings suggest that sponsorship bias could lead to higher drug prices in low- and middle-income countries with fewer resources to pay for health care.

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