TO THE EDITOR: In reading your March/April 2010 issue, I could not help noticing that the study "Healthcare Costs Associated with Switching from Brand to Generic Levothyroxine"1 was funded by Abbott Laboratories, and 3 of the authors are paid consultants for Abbott.1 It amazes me that your publication would not recognize that these relationships pose a serious conflict of interest and not reject the publication of such a study, because of these inherent potential biases.
1. Katz M, Scherger J, Conard S, et al. Healthcare costs associated with switching from brand to generic levothyroxine. Am Health Drug Benefits. 2010;2:127-134.
Kevin Slavik, RPh, MHA
Sr Director of Pharmacy
Health Care Service Corporation
BlueCross BlueShield of Chicago, IL, Texas, New Mexico, and Oklahoma
EDITOR'S RESPONSE: Thank you for your thoughtful comment and for the opportunity to address this important issue in American Health & Drug Benefits. The question of a potential bias of any article published in the journal is indeed a major concern for us, as it is for many healthcare publications.
Unlike many publications in the industry, however, it is the mission of this journal to encourage submission of articles from all those who have a stake in healthcare—including payers, employers, insurers, providers, government agencies, patient advocacy groups, and yes, pharmaceutical companies—in support of our fundamental goal of stakeholder integration for the improvement of healthcare. It is the stated objective of this journal to promote an open dialogue among all those participating in healthcare toward the promotion of health and wellness in the United States.
To ensure that articles published in this journal are free of bias and therefore have the potential to benefit various stakeholders, we conduct a very strict, carefully managed, and often prolonged peer-review process. This process at times appears to be detrimental to the idea of expediting the publication of an article and potentially even alienating some authors, but we make no exceptions to this thorough process that was established with the launch of this journal. Each article is reviewed by 2 or 3 (and at times 4 or 5) reviewers, most of whom are either readers of this journal or members of the editorial board, all with specific healthcare expertise.
Although the peer review is conducted in a blinded fashion, according to which authors' names and affiliations are withheld from the reviewers, any study support from a commercial or a public body is fully disclosed to the reviewers and subsequently to the readers, as was the case with this particular article. Reviewers are asked specifically to assess the potential bias of each article, and any suggestion of bias in the content of the article is a reason for immediate rejection of that article.
In addition, according to our author disclosure policy, all authors must sign a disclosure form for each article, listing all their potential conflicts of interest, and any such information is subsequently listed with the published article, as was the case with this article.
Finally, although Abbott paid for the study itself, it did not provide any support for the publication of the article, nor did it have any influence on the publication or the editing of the article; the latter entails careful fact-checking of all factual statements and references. Indeed, none of the articles published in this journal (to differentiate from journal supplements) is supported by any outside funding.