REVIEW Scope and Impact of Financial Conflicts of Interest in Biomedical Research A Systematic Review

INDUSTRY SUPPORT OF BIOMEDICALresearch in the United States in-creased dramatically in the last 2decades. Industry’s share of total in-vestment in biomedical research andde-velopment grew from approximately 32 % in 1980 to 62 % in 2000, while the federal government’s share fell.1,2 Dur-ing this period, the relationship be-tween academic institutions and indus-try flourished, spawning medical advances, creating new biotechnology markets, and providing needed sup-port for further discovery. However, an entanglement of relationships among industry, investigators, and academic institutions also emerged. Conflicts of interest are “a set of con-ditions in which professional judg-ment concerning a primary interest (such as a patient’s welfare or the va-lidity of research) tends to be unduly influencedby a secondary interest (such as financial gain).”3 Financial inter-ests are not the only, or necessarily the most powerful, secondary interests faced by investigators and academic in-stitutions. For investigators, other pres-sures, including the desire for profes-sional recognition and the need to compete successfully for research fund-ing, are intrinsic to the research pro-cess.4 Institutions also confrontmyriad pressures arising from balancing the needs of diverse departments and con-stituencies. However, financial inter-ests related to biomedical research are nonobligatory and often unrecog-nized unless disclosed. They are the fo-cus of current national discussion be-cause they induce public anxiety about the influence of money on the re-search process.3,5,