The morning the email arrived announcing that Vioxx was being recalled by its manufacturer, I immediately notified the Editor-in-Chief of the New England Journal of Medicine. Over the years and under various editors, NEJM had published important research about Vioxx in early trials. The news now was that an ongoing trial had subsequently shown increased risks of heart attack and stroke with long-term use, and the drug’s maker (Merck) was withdrawing Vioxx from the market. Because NEJM had been involved in publishing studies showing both benefits and risks, many subsequent months were spent as the editors responded to various parties seeking information about Merck’s conduct during the preceding years.
One surprising aspect of the Vioxx story was that Merck, a company that until then had possessed a largely untarnished reputation for promoting health and well-being, was involved in pushing Vioxx aggressively while suppressing information about known risks. This was the same Merck that has published for decades its trusted and unbiased Merck Manual, and that had developed a sterling reputation for sound science funding and excellent drug and chemical manufacturing. However, the company had also adapted behind the scenes to the new world of drug sales and research promotion — aggressive marketing and information management, as the euphemisms might go. According to one policymaker writing shortly after the recall, Merck:
. . . trained its representatives to identify speakers for educational events who were “opinion leaders” who could provide “favorable” views of the company’s products to other doctors. Underlining the promotional nature of these events, Merck instructed its sales representatives to track whether the physicians who attended them subsequently prescribed more Merck drugs. . . . it would be a mistake to restrict the lessons learned to a single company. The testimony we heard indicated that Merck’s marketing practices may be less aggressive and more ethical than those of many of its competitors.
While the behavior was unusual from Merck,* the problems stemming from corporations involving themselves in research had been long simmering in medical publishing, with controversies over funded supplements, research sponsorship, and publication planning initiatives testing organizational firewalls, editorial policies, and ethical norms. It’s unclear how well medical publishers had been or have been able to identify and manage these involvements, some of which can be quite subtle and even hidden entirely. Sometimes, a researcher will misbehave for no reason other than to become famous, which makes it all the harder to sense when something is amiss.
Whistleblowing accelerated nonetheless after the Vioxx recall, which was a bit of a bellwether, with drugs like Avandia and others getting black box warnings after researchers ferreted out that a great deal of information had been suppressed about possible health risks. Clinicaltrials.gov was established largely to make it harder for companies to suppress information about clinical trials.
Fast-forward a decade or more and many changes in how academic research (and academia itself) is funded, how government supports scientific researchers, and how tenure tracks and academic lifestyles are managed, and we find an environment in which 65.2% of funding of research comes from business, according to the 2016 Science & Engineering Indicators from the National Science Board, with 26.7% of research funding comes from government. This represents a slow reversal over the past 40 years, where the two lines intersected as business’ share of R&D expenditures climbed and government’s fell. Now, business funds nearly 3x as much research as the government.
During this time, corporations have been allowed to become larger than at any time in living memory. This was largely caused by the advocacy of Robert Bork and others affiliated with “the Chicago school” of economic thinking, which argued that the previous, vague political unease that “big is bad” wasn’t based on empirical evidence, and that a free market would govern large firms through pricing and other competitive practices. Now, with the emergence of online platforms and evidence that the market does not manage “big” well as mergers have been allowed to proliferate virtually unchallenged, a new thread of thinking is emerging. In a paper entitled, “Amazon’s Antitrust Paradox,” Lina M. Khan from Yale argues:
First, the economics of platform markets create incentives for a company to pursue growth over profits, a strategy that investors have rewarded. Under these conditions, predatory pricing becomes highly rational — even as existing doctrine treats it as irrational and therefore implausible. Second, because online platforms serve as critical intermediaries, integrating across business lines positions these platforms to control the essential infrastructure on which their rivals depend. This dual role also enables a platform to exploit information collected on companies using its services to undermine them as competitors.
Now, larger corporations dominate markets, something that is drawing active intervention in Europe and may be creating a larger regulatory backlash in many countries. Yet, in the US, little has changed.
At the same time, government science funding is even more hamstrung than it may appear. The uncertainty created by the Trump Administration is hampering research without delivering direct cuts, a recent analysis by Bloomberg Government has shown. Because federal agencies can carry over funding from one year to another, the response to this uncertainty has been a decrease of 16% in the value of R&D contracts awarded by these agencies compared to the prior year. Comparing this to the first seven months of President Obama’s presidency, the decline in awards is more than 5x that rate of slowdown.
With the science of information now also front-and-center, as recounted brilliantly in James Gleick’s masterful book, The Information, we are now seeing large information companies like Google and Monsanto (genes are information) caught up in scandals about how they’re funding research and researchers.
Journals have become tools in corporate battles
With large corporations participating, you may think you’d see a lot of large deals. Initially, some occurred, such as when the University of California, Berkeley and BP teamed up for a 10-year, $500 million research deal on alternative energy. The deal later fell apart in a very public manner. It turns out that when the market changes, so does the willingness to fund long-term research projects. Instances like this may be why corporate sponsors, universities, and researchers all favor smaller deals that remain out of the limelight and carry less risk of falling apart. In fact, smaller influence may be quite difficult to detect.
Google’s role in research funding was recently uncovered in an impressive story in the Wall Street Journal, outlining how “gifts” from Google targeting economists and other researchers pursuing initiatives potentially friendly to Google’s lobbying efforts were commonplace. There were issues with potential meddling from Google, as well as lack of disclosure and feather-bedding:
Some researchers share their papers before publication and let Google give suggestions, according to thousands of pages of emails obtained by the Journal in public-records requests of more than a dozen university professors. The professors don’t always reveal Google’s backing in their research, and few disclosed the financial ties in subsequent articles on the same or similar topics, the Journal found. . . . Google promotes the research papers to government officials, and sometimes pays travel expenses for professors to meet with congressional aides and administration officials, according to the former lobbyist. The research has been used, for instance, to deflect antitrust accusations against Google by the Federal Trade Commission in 2012, according to a letter Google attorneys sent to the FTC chairman and viewed by the Journal.
Journals have become tools in corporate battles as chip-maker Qualcomm Inc. funded papers supporting its side of a fight against Google over patents. Telecommunication giants Verizon Communications Inc. and AT&T Inc. have funded various papers against Google. Research bleeds into advocacy, and advocacy bleeds into research. The boundary becomes difficult to identify.
In some cases, the boundary is purposely smudged, disappearing like the batter’s box in a baseball game as the innings progress. Monsanto has been caught recently meddling in and managing scientific outputs to achieve corporate ends. This includes supporting a supposedly independent supplement in a toxicology journal, one apparently designed to provide evidence to dispute or refute claims that Monsanto’s Roundup may be a carcinogen, something the WHO has determined. Internal emails released by an attorney suing Monsanto show leadership at the agricultural giant meddling in editorial matters in the supplement. There is also evidence that at least one Monsanto researcher was erased from a separate toxicology study:
Other emails show that Monsanto’s lead toxicologist, Donna Farmer, was removed as a co-author of a 2011 study on glyphosate’s reproductive effects, but not before she made substantial changes and additions to the paper behind the scenes. The study . . . served to counter findings that glyphosate hampers human reproduction and development. Partridge says Farmer’s contributions didn’t warrant authorship credit. While almost all of her revisions made it into the published paper, her name doesn’t even show up in the acknowledgments.
If somebody came to me and said they wanted to test Roundup I know how I would react — with serious concern.
It’s worth noting that this is a scientist employed by Monsanto, who for at least 16 years has apparently kept his or her concerns quiet, perhaps out of concern about employment, perhaps out of loyalty, or for those and other factors. The point is that being a scientist doesn’t automatically make someone a whistleblower, and as more research is funded by and conducted by corporations, scientists become employees serving bosses.
Those promoting a more author-centered market seem to assume that authorship will be unencumbered, trustworthy, and purely academic. However, if this is not the case, then in a period when pre-prints, institutional repositories, and original manuscripts abound, so do potential time bombs within them.
Of course, this is nothing new at heart, from cigarette companies claiming “more doctors smoke Camels” to more recent assertions that climate scientists themselves have been conflicted by their interests in carbon trading companies. But now we have to look for conflicts of interest and corporate manipulation in places we perhaps didn’t expect. On top of this, the players are even larger, more sophisticated and creative, and more global than before. We may be in a new phase of corporate research.
Pollution of the scholarly literature by corporate influence could lead to decreased trust in the results published in peer-reviewed journals and other outlets (monographs, for example). We’ve seen this many times with studies of nutrition. While not directly tied to the success of “fake news” and propaganda campaigns more generally, these placements do make it harder to point to a standard of truth against which other information sources can be justly measured.
Given the promulgation of large corporate interests wanting to use scientific reports as a megaphone, there are more and more reasons to check on the employment status of authors, the funding underpinning research, and the completeness of disclosures or even authorship lists. What was once mainly a concern for medical journals is now becoming a concern in many other areas, as larger corporations see research publication as an effective adjunct to lobbying, promotion, and public relations.
* Note: Merck’s strong ethical reputation continues, as their CEO has quit a council organized by President Trump, due to the President’s failure to condemn white supremacists in Charlottesville.