Scientific journals, some of which sell subscriptions for thousands of dollars, currently retain control over the published information. The proposal, which NIH has been considering for more than a year, would require federally funded researchers to submit their papers to the agency after they have been accepted for publication and edited by a journal, the Post reports.

The journals would be given six months to "profit from the work," which would then be made available at no cost on NIH's Internet database, PubMed Central, according to the Post.

While the scientific publishing industry has said that the proposal would force some journals to go out of business and cause some scientific societies to declare bankruptcy, even those opposing the move have said some sort of change in the current system is "inevitable," the Post reports.

NIH Director Elias Zerhouni, who has held three meetings on the issue with industry officials and patient advocates over the past six weeks, said, "The status quo is not an option." According to the Post, the move, which could "trigge[r] a global open-access revolution," gained "new momentum" recently with report language by the House Appropriations Committee.

The report stated, "The committee is very concerned that there is insufficient public access to reports and data resulting from NIH-funded research. This situation ... is contrary to the best interests of the U.S. taxpayers who paid for this research." The report advised NIH to create a system that would allow results to be "freely and continuously available no later than six months after publication," according to the Post.

Reaction

Roberta Arnold of the Radiological Society of North America said, "If the NIH has to increase the size of its grants or make other major expenditures to implement a new, open-access system, taxpayers will end up paying more money for less research."

However, Zerhouni said that the industry's reaction was "way out of line" with the actual costs of the proposal. Richard Roberts, a research director at New England Biolabs and one of 25 Nobel laureates who recently signed a letter in support of open access, said, "There's lots of free junk and advertisements for snake oil on the Internet, but people can't get the good research unless they pay for it. That does not seem right."

Roberts added that scientific journals would continue to attract subscribers because NIH-funded papers only make up about one-third of the total research published each year, and several publications feature analysis and commentary, according to the Post. Alan Leshner, president of the American Association for the Advancement of Science, which publishes the journal Science, said that the proposal addresses "some of the concerns" publishers have expressed since the congressional report was released and "appears to be a reasonable compromise."

Science is one of several journals that provides its articles to the public at no cost 12 months after publication. Sen. Arlen Specter (R-Pa.), who heads the Senate appropriations subcommittee overseeing NIH, said he generally supports open access and hopes a reasonable policy resulting from public input will soon emerge.

However, he added that no supportive language on the measure would be included in the upcoming appropriations bill. The proposal is open to a public comment period for the next 60 days (Weiss, Washington Post, 9/6).

Merck To Post Clinical Results on NIH Site

In related news, Merck on Friday announced that it plans to post all of its clinical trial results "well before they are completed" on NIH's Internet registry of experimental clinical trials in an effort to "expand the purpose and scope" of the Web site and make it "the standard for the rest of the industry," the New York Times reports.

According to Merck officials, the company already has posted the protocols for 46 of its ongoing studies on the site, and it plans to post by the end of this month the outlines of 50 more trials that are currently under way.

Merck plans to post links to the studies' results as they are published. According to the Times, Merck "has a history of publishing clinical trials even when the results reflected poorly on its drugs," while many other companies have "long declined to make public" negative trial data (Harris, New York Times, 9/6).

GlaxoSmithKline last month agreed to settle a lawsuit filed by New York Attorney General Eliot Spitzer that will require the company to post all of its clinical trial results online by the end of 2005. The lawsuit alleged that GSK withheld data from clinical trials that indicated the antidepressant Paxil is no more effective in adolescents and children than a placebo and in some cases is more likely than a placebo to cause suicidal thoughts (Kaiser Daily Health Policy Report, 8/27).

Merck Senior Vice President Peter Honig said, "Merck has long been committed to publishing the results of all of our trials in a timely manner and now we're strengthening that commitment." Honig added that more companies should make their results public because "the perceptions of the pharmaceutical industry as a whole are not healthy at the moment."

A spokesperson for Sen. Edward Kennedy (D-Mass.) said that despite Merck's move, legislation on the matter is still needed. The spokesperson said, "A bill is needed because voluntary measures by companies, while generally laudable, will not produce the comprehensive information the public needs and deserves to assess the safety and effectiveness of the medicines they take." Kennedy is expected to introduce a measure requiring full clinical result disclosures as early as this week (New York Times, 9/6). Rep. Henry Waxman (D-Calif.) is also working on a government registry bill.

PhRMA Releases Plan

The Pharmaceutical Research and Manufacturers of America on Tuesday planned to release its plan for a voluntary online registry that would include summary results of most of its members' studies, including results not published in medical journals.

According to the Wall Street Journal, PhRMA's database, which would publish results within a year of their conclusion, "goes well beyond the industry's efforts so far" but is "certain to draw questions because [it] fall[s] short of what doctors and other groups are requesting."

The database would feature only summaries of unpublished studies; would exclude some data, such as early-stage studies and unfinished trials; and would contain only trials completed after Oct. 1, 2002. PhRMA said most, if not all, of its members will participate in the program, which would eventually be turned over to an outside group such as a medical association.

PhRMA Associate Vice President Alan Goldhammer said the registry will "fill the gap" and "increase the transparency of trial results." He added that the group is open to expanding the amount of information available on the site, which is set to launch Oct. 1.

However, PhRMA's proposal "in some ways promises less than what some individual drug companies," including Merck, have already agreed to make public, the Journal reports. David Fassler, a Vermont psychiatrist, said a voluntary registry would not be effective.

"Without an enforcement mechanism, we can't be sure that the data will actually get submitted and updated on a timely basis," Fassler said. The issue "will to come to a head Thursday" at a "high-profile" congressional hearing on antidepressant trials done on children and adolescents, the Journal reports. The American Medical Association and a group of editors from major medical journals are expected this week to give more detail on their separate proposals for clinical trial registries (Wilde Mathews, Wall Street Journal, 9/7).