Mapping conflict of interests: scoping review

A scoping review of the literature to identify all known ties between the medical product industry and the parties and activities in the healthcare ecosystem.


Originally published on 11/03/2021 in BMJ

The range and interrelationships of company ties across the healthcare ecosystem are incompletely described.

The medical product industry maintains an extensive network of ties across the healthcare ecosystem. Most studies of conflict of interests related to pharmaceutical, medical device, and biotechnology companies have focused on one party (eg: prescribers, organizations) or activity (eg: research, education, clinical care) in the healthcare ecosystem.

Researchers at the Drug Pricing Lab created a map through a scoping review of the literature and expert input to show the network of medical product industry ties across all parties and activities in the healthcare ecosystem. The map was derived through synthesis of 538 articles from 37 different countries and is available as an interactive tool on our website.

The map also shows that this network of ties is often unregulated and non-transparent. Enhanced oversight and transparency are needed to shield patient care from commercial influence and to preserve public trust in healthcare.


Key Takeaways

The medical product industry maintains an extensive network of financial and non-financial ties with all major healthcare parties and activities.

This network seems to be mostly unregulated and opaque.

It is therefore up to other key parties, including the healthcare profession and policy makers, to effectively manage commercial influence, protect patient safety, and ensure public trust.

“Physicians, researchers, and the institutions that carry out medical research and education, provide patient care, and develop practice guidelines do not act in isolation but, rather, as part of complex intersecting systems.” Institute of Medicine

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