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March 15, 2000

Sources of Bias in the Economic Analysis of New Drugs

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(11):1423-1424. doi:10.1001/jama.283.11.1421

To the Editor: Mr Friedberg and colleagues1 have analyzed a sample of published pharmacoeconomic studies and found that "pharmaceutical company-sponsored studies were less likely than nonprofit sponsored studies to report unfavorable qualitative conclusions." It is important to notice that they identified a publication bias, not a study bias. In fact they fail to find biases in individual studies, meaning that the peer review process work reasonably well and that individual published studies are generally reliable. However, it is also important to encourage publication of negative results. We recently published a study with negative results2 despite reservations from the referees. We felt that they would have been more enthusiastic about positive results. Clinicians may also fear that reporting negative cost-effectiveness results will reinforce nonmedical limitations to their autonomy to prescribe.

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