Financial Conflicts of Interest in Propensity Score-Matched Studies Evaluating Biologics and Biosimilars for Inflammatory Bowel Disease

Abstract

Background Propensity score matching (PSM), a statistical technique that estimates a treatment effect by accounting for predictor covariates, has been used to evaluate biologics for inflammatory bowel disease (IBD). Financial conflicts of interest are prevalent in the marketing of biologic medications. It is unclear whether this burden of conflicts is present among authors of PSM studies comparing IBD biologics and biosimilars. Objective This study was aimed to determine the prevalence of financial conflicts of interest among authors of PSM studies evaluating IBD biologics and biosimilars. Methods We conducted a systematic search for PSM studies comparing biologics and biosimilars in IBD treatment. We identified 21 eligible studies. Two independent authors extracted self-declared conflicts from the disclosures section. Each participating author was searched on the Centers for Medicare & Medicaid Services Open Payments to identify payment amounts and undisclosed conflicts. Primary outcome was the prevalence of author conflicts. Secondary analyses assessed for an association between conflict prevalence and reporting of positive outcomes. Results Among 283 authors, conflicts were present among 41.0% (116 of 283). Twenty-three per cent (27 of 116) of author conflicts involved undisclosed payments. Studies with positive outcomes were significantly more likely to include conflicted authors than neutral studies (relative risk = 2.34, 95% confidence interval: 1.71 to 3.21, P < 0.001). Conclusions Overall, we found a high burden of undisclosed conflicts among authors of PSM studies comparing IBD biologics and biosimilars. Given the importance of PSM studies as a means for biologic comparison and the potential for undue industry influence from these payments, authors should ensure greater transparency with reporting of industry relationships.

The undisclosed disclosures: The dollar-outcome relationship in resuscitative endovascular balloon occlusion of the aorta

“…The burden of inaccurate COI disclosure in medicine has been reported using the OPD across various specialties ranging from robotics, orthopedics, gastroenterology, and ophthalmology to occupational health research. 3,5,[18][19][20] Hsieh et al 21 reported that nearly 97% of the authors of 100 US-based top-cited image-guided procedure publications failed to accurately disclose their COI. Inaccurate COI disclosures are highly common even among high-impact journals.…”

“…These physician-industry relationships are important for technological advancement; however, these ties introduce a potential source of bias that may influence research findings. Studies have shown that physician researchers who receive payments from industries are more likely to demonstrate results favorable to the funding companies and prescribe drugs and devices produced by these companies 4,5 . They may also unduly influence other physicians by contributing to articles that other providers use to guide their own clinical practice 6,7 …”

“…Studies have shown that physician researchers who receive payments from industries are more likely to demonstrate results favorable to the funding companies and prescribe drugs and devices produced by these companies. 4,5 They may also unduly influence other physicians by contributing to articles that other providers use to guide their own clinical practice. 6,7 Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a controversial technology developed in the process of continued efforts to invent novel methods for hemorrhage control, especially noncompressible torso hemorrhage.…”