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Financial Relationships With Industry Among National Comprehensive Cancer Network Guideline Authors
Aaron P Mitchell1, Ethan M Basch1, Stacie B Dusetzina2
1Department of Hematology/Oncology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill2Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.
Importance:
Financial conflicts of interest (FCOIs) among authors of clinical practice guidelines have the potential to influence treatment recommendations.
Objective:
To quantify FCOIs with industry among authors of the National Comprehensive Cancer Network (NCCN) guidelines.
Design, Setting, And Participants:
We assessed FCOIs occurring during 2014 among NCCN guideline authors in the United States. All were physician members of the NCCN guideline committees for lung, breast, prostate, and colorectal cancer as of the end of 2014. The data source for FCOIs was Open Payments, which is publically reported by the Centers for Medicare and Medicaid Services. This study was cross-sectional.
Main Outcomes And Measures:
The proportion of NCCN authors having FCOIs with industry; the average amount received from industry sources per author.
Results:
Of 125 guideline authors, 108 (86%) had at least 1 reported FCOI. Authors received an average of $10 011 (range, $0-$106 859) in general payments (GPs), which include consulting, meals, lodging, and similar transfers of value, and $236 066 (range $0-$2 756 713) in industry research payments (RPs), including funding associated with clinical trials. Approximately 84% of authors received GPs, while 47% received RPs. Eight (6%) had FCOIs in excess of the $50 000 net and/or $20 000 single-company maximums stipulated by NCCN.
Conclusions And Relevance:
Among NCCN guideline authors, FCOIs involving RPs were of greater value, while those involving GPs were more prevalent. Although FCOIs may result from engaging in important scholarship, FCOIs may still influence guideline authors in counterproductive ways. Research is needed to understand how best to manage author FCOIs during guideline creation.