Mello Michelle M, Clarridge Brian R, Studdert David M
Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA.
N Engl J Med. 2005 May 26;352(21):2202-10. doi: 10.1056/NEJMsa044115.
Although industry sponsors provide approximately 70 percent of the funding for clinical drug trials in the United States, little is known about the legal agreements that exist between industry sponsors and academic investigators. We studied institutional standards regarding contractual provisions that restrict investigators' control over trials.
We used a structured, cross-sectional mail survey of medical-school research administrators responsible for negotiating clinical-trial agreements with industry sponsors.
Of 122 institutions approached, 107 participated. There was a high degree of consensus among administrators about the acceptability of several contractual provisions relating to publications. For example, more than 85 percent reported that their office would not approve provisions giving industry sponsors the authority to revise manuscripts or decide whether results should be published. There was considerable disagreement about the acceptability of provisions allowing the sponsor to insert its own statistical analyses in manuscripts (24 percent allowed them, 47 percent disallowed them, and 29 percent were not sure whether they should allow them), draft the manuscript (50 percent allowed it, 40 percent disallowed it, and 11 percent were not sure whether they should allow it), and prohibit investigators from sharing data with third parties after the trial is over (41 percent allowed it, 34 percent disallowed it, and 24 percent were not sure whether they should allow it). Disputes were common after the agreements had been signed and most frequently centered on payment (75 percent of administrators reported at least one such dispute in the previous year), intellectual property (30 percent), and control of or access to data (17 percent).
Standards for certain restrictive provisions in clinical-trial agreements with industry sponsors vary considerably among academic medical centers. Greater sharing of information about legal relationships with industry sponsors is desirable in order to build consensus about appropriate standards.
尽管在美国,行业赞助商提供了约70%的临床药物试验资金,但对于行业赞助商与学术研究人员之间存在的法律协议,人们了解甚少。我们研究了关于限制研究人员对试验控制权的合同条款的机构标准。
我们对负责与行业赞助商协商临床试验协议的医学院研究管理人员进行了结构化的横断面邮件调查。
在被联系的122家机构中,107家参与了调查。管理人员对一些与出版物相关的合同条款的可接受性达成了高度共识。例如,超过85%的人报告称,他们的办公室不会批准赋予行业赞助商修改稿件或决定结果是否发表的权力的条款。对于允许赞助商在稿件中插入其自己的统计分析(24%的人允许,47%的人不允许,29%的人不确定是否应该允许)、起草稿件(50%的人允许,40%的人不允许,11%的人不确定是否应该允许)以及禁止研究人员在试验结束后与第三方共享数据(41%的人允许,34%的人不允许,24%的人不确定是否应该允许)的条款的可接受性,存在相当大的分歧。协议签署后纠纷很常见,且最常集中在付款(75%的管理人员报告上一年至少有一次此类纠纷)、知识产权(30%)以及数据的控制或获取(17%)方面。
学术医疗中心之间,与行业赞助商签订的临床试验协议中某些限制性条款的标准差异很大。为了就适当的标准达成共识,需要更多地分享与行业赞助商法律关系的信息。