The leadership of the international Cochrane Collaboration failed to make a decision on drug company sponsorship at last week's annual conference in Barcelona, opting instead for a complex consultation with its 10 000 members.
Professor Jim Neilson, who co-chairs the collaboration's steering group, told the BMJ a discussion paper will be released next month, and a final decision will be made in February. "The members have made it very clear they want to have input into this decision."
The Cochrane Collaboration (www.cochrane.org) produces systematic reviews of the evidence about healthcare interventions, but its supporters are deeply divided over how to manage their relationships with private companies, particularly drug manufacturers.
Pointing to the well established association between sponsored research and favourable outcomes, some people within the collaboration want a prohibition on reviews funded by industry. Others argue that such funding is critical to the group's survival, particularly in countries where state support is lacking.
Speaking near the conclusion of the Barcelona meeting, Professor Neilson said details of the consultation process were still being finalised, but a vote was not being considered. "We're looking for consensus," he said, explaining that a special email address would be set up to receive potentially thousands of responses.
The key sponsors of the Barcelona conference—which coincided with the collaboration's 10th anniversary—were an airline and five drug companies, including Merck Sharpe & Dohme, Novartis, and AstraZeneca, whose logos were prominently displayed on the first page of the conference's programme booklet.
Debate about funding from vested interests dominated the formal and informal meetings at the collaboration's annual colloquium.
A key architect of the move towards evidence based medicine, Professor Gordon Guyatt of McMaster University, Hamilton, Ontario, is one of the Cochrane supporters who are now open to the idea of sponsorship from drug companies. Once considered a critic of drug industry influence in medicine, Professor Guyatt recently helped produce a series of reviews on osteoporosis treatments that were partly funded by a $150 000 (£90 000; €130 000) grant from Merck Sharpe & Dohme, which makes an osteoporosis drug.
"Having had this positive experience, I've lost my objectivity on this issue," he said, at the same time suggesting a compromise solution that would allow industry funding to flow through an independent trust, ensuring no connection between donors and reviewers.
Others, such as Dr Andy Oxman, a former chairman of the Cochrane Collaboration's steering group, fear that the group could lose its reputation for independence and integrity. "I think we should stop taking money from industry," he said.
Dr Oxman also argues that a false dichotomy is being made between private money and public money—because such a large proportion of drug company revenue flows directly from publicly subsidised health systems. "The problem is [that] private decisions are being made about how to spend public money," he said.