Medical Journal finances and reprints

High reprint orders in medical journals and pharmaceutical industry
funding: case-control study

Perhaps the most striking thing about this article is the refusal of
the American publishers, all of which are doctors’ organisations, to
provide any data. Inevitably readers will wonder what they are hiding.
The answer, I suspect, is the massive profits that they are making
from selling reprints of pharmaceutically funded research.

We know that something like 50% of all drug sales are in North
America, and reprints are a major device for promoting drugs.
Cynically, I suggest that the point of reprints is not to provide
doctors with scientific data but rather to link the drug company’s
product to the prestigious brand of the journal. My bet is that well
over 80% of reprints are never read.

The second striking figure from this paper is the Lancet sale of a
reprint for more than £1.55m. What the authors don’t say (and perhaps
don’t know) is that the profit margin on reprints is something like
80%. Reprints are particularly attractive to publishers less for the
revenue and more for the profit. Paper subscriptions are nothing like
as profitable. So Elsevier, the owners of the Lancet, made a profit of
well over a million pounds from the Lancet publishing this one study.
That’s one of the reasons why Elsevier manages to make a profit margin
over 30%, which is far higher than in most industries.

The conflict of interest is clearly huge. If Elsevier had to maintain
its profit margin by cutting costs rather than publishing that one
article it would have to fire about 25 editors (assuming an average
salary plus oncosts of about £40 000).

Because the American market is so huge and important the American
journals, and particularly the New England Journal of Medicine, may
well be making more from reprints than the Lancet. I suggest that
doctors who belong to the organisations that publish the journals ask
to see the budgets of their journals.

This rapid response overlaps to some degree with a blog that I hope
the BMJ will be willing to post.

Competing interests: RS was the editor of the BMJ and the Chief
Executive of the BMJ Publishing Group. He is a zealot for open access
and was from 2004 to 2011 a member of the board of the Public Library
of Science.