A new research letter published in the Journal of the American Medical Association (JAMA) revealed that most peer reviewers for medical journals are given industry payments.

The payments, which are given to physicians who conduct peer reviews by drug and medical device makers, totaled $1.06 billion across the three years studied.

This is clearly a conflict of interest, and while journals often have conflict-of-interest policies that are applied to authors, very few hold peer reviewers to the same standard.

The researchers looked at the general and research payments that doctors serving as peer reviewers for major journals were given by drug and device manufactures from 2020 to 2022.

Some of the publications studied included The Lancet, The New England Journal of Medicine, BMJ and even JAMA, who published the research letter.

University of Toronto urology resident physician David-Dan Nguyen, who authored the study, said: “Although conflicts of interest of journal editors and authors have been investigated, the traditionally opaque nature of peer review has hindered their evaluation among peer reviewers, despite their crucial role in academic publishing.”

They studied the peer reviewer lists of each journal and compared it to information from the Open Payments database about general and research payments. More than 7,000 reviewers were initially listed, but this was narrowed down to 1,962 after excluding those who were not physicians or were not located in the U.S.

They found that nearly 59% of the reviewers were given at least one industry payment during the period studied. Among this group, more than half received general payments and 31.8% received research payments.

The money awarded included more than $1 billion given to individuals or their institutions, more than $64 million in general payments, $11.8 million in speaking compensation fees and more than $34 million in consulting fees.

Peer reviewers rake in thousands of dollars from pharmaceutical companies

Just how much is a peer review worth in today’s market? The researcher found that the median research payment was a generous $153,173, while the median general payment was $7,614. There was a notable divide across genders, with male reviewers enjoying a median total payment of $38,959 versus $19,586 for women; the difference in general payments was a median of $8,663 for male reviewers versus $4,183 for female reviewers. The payments also varied by specialty, with some earning significantly more than others.

The authors pointed out that they did not consider payments from entities such as technology and insurance companies, which means they could be underestimating the payments reviewers are given.

Many times, studies are considered more reliable if they bear the “peer reviewed” label, but research like this shows us how little the term really means.

"Peer reviewers act as critical arbiters of both the validity and relevance of peer-reviewed studies. Therefore, understanding the potential intellectual and financial relationships that may affect their decision making is key to understanding how these influences affect the peer-reviewed literature," said study co-author Dr. Christopher Wallis of the University of Toronto.

Unbiased information about medical care is hard to find

These days, it’s hard to find unbiased information about medical care; even doctors aren’t reliable as they increasingly receive kickbacks from pharmaceutical companies for prescribing their drugs.

One study by ProPublica found more than 700 doctors who had received at least $1 million in kickbacks from pharmaceutical companies, raising doubts about what motivates them to prescribe a drug and whether it is truly needed in every case they write a prescription for it.

Sources for this article include:

JAMANetwork.com

Healio.com

MedPageToday.com

ProPublica.org