The BMJ Investigations Unit

2024

Exclusive: Outcry as Philip Morris International funds smoking cessation courses on Medscape
A leading medical information company has been urged to cancel a series of new education courses on smoking cessation funded by the tobacco industry giant Philip Morris International (PMI)

Delays in dealing with complaints against drug companies are growing, BMJ finds
A major backlog has developed in handling complaints over drug companies’ marketing practices in the UK. Hristio Boytchev, Shai Mulinari, and Piotr Ozieranski report

2023

Lax oversight of semaglutide advertising could harm patients, warn critics
UK organisations responsible for protecting the public from advertisements of prescription-only drugs are putting patients at risk from the harms of weight loss drugs by not enforcing the law, critics have told The BMJ

Concerns over informed consent for pregnant women in Pfizer’s RSV vaccine trial
A debate has broken out over whether Pfizer should have told pregnant women taking part in its maternal RSV vaccine trial that a trial of a similar GSK vaccine was stopped over a safety signal around preterm birth

Is the US’s Vaccine Adverse Event Reporting System broken?
A BMJ investigation has raised concerns that the VAERS system isn’t operating as intended and that signals are being missed. Jennifer Block reports

The FDA and Moderna’s cosy relationship: how lax rules enable a revolving door culture
After holding oversight roles for covid vaccines, two regulators from the US Food and Drug Administration went to work for Moderna. Peter Doshi reports

Trusts are accused of using foreign doctors as “cheap labour” in fellowship schemes
Overseas doctors on an England-wide trainee scheme are being paid less than trainees employed by trusts and face reduced benefits, finds Madlen Davies

The US quietly terminates a controversial $125m wildlife virus hunting programme amid safety fears
Two years after launching what officials hailed as a five year flagship project for hunting viruses among wildlife to prevent human pandemics, the US Agency for International Development is shuttering the enterprise. David Willman reports

Unreliable private online hormone tests sold for months despite accuracy concerns
Potentially unreliable online tests for oestrogen were sold for months after questions were raised over their accuracy. Inaccurate results could impact decisions around fertility and medication, prompting questions about the regulation of private laboratories. Emma Wilkinson reports

How the FDA approved an antipsychotic that failed to show a meaningful benefit but raised the risk of death
In trials, brexpiprazole failed to provide a clinically meaningful benefit and it increased mortality, but the FDA fast tracked its approval. Robert Whitaker investigates the first licensed antipsychotic for treating agitation in elderly patients with dementia

Medical royal colleges receive millions from drug and medical devices companies
Medical royal colleges do not always disclose publicly the millions of pounds they receive from drug and medical device companies. Critics say voluntary industry transparency initiatives don’t go far enough. Hristio Boytchev reports

Neuroscience or stealth marketing? Experts alarmed at free Barbies for primary schools to teach social skills
Free dolls were given to 700 UK schools as part of Mattel’s “Barbie School of Friendship” programme, which the company says was based on neuroscience research, but critics are worried about overt marketing. Hristio Boytchev reports

Row over medical journal’s refusal to retract paper used to restrict abortion in US legal cases
A highly critiqued paper in a British journal has been cited in US legal cases to restrict access to abortion. Attempts to retract the paper by insiders at the journal have failed, leading to a row over editorial independence. Madlen Davies reports

The deadly legacy of a stem cell charlatan
Paolo Macchiarini misled the world over his breakthroughs in regenerative medicine, but why did most of the institutions that supported him bear no responsibility for hosting a rogue stem cell surgeon? It’s time for them to launch full and independent investigations, argue John Rasko and Carl Power

Medical colleges and unions call for inquiry over “shocking” levels of sexual assault in the NHS
NHS trusts recorded more than 35,000 cases of rape, sexual assault, harassment, stalking, and abusive remarks between 2017 and 2022, but only one in 10 trusts has a dedicated policy to manage the problem. Ingrid Torjesen and Adele Waters investigate

Did the FDA break its own rules in approving the antibiotic Recarbrio?
FDA scientists said that they couldn’t draw any inferences from the clinical trials for a new combination antibiotic from Merck—but the agency approved Recarbrio anyway. Peter Doshi investigates

The decline of science at the FDA has become unmanageable
The Recarbrio approval is a sentinel event, warning of a return to an era when drug effectiveness was an afterthought, writes David B Ross

GMC is criticised for investments in Nestlé and McDonald’s
Doctors have criticised the General Medical Council after The BMJ found that the regulator had investments in fast food firms, drug companies, private medical insurers, and private healthcare providers

Gender dysphoria in young people is rising—and so is professional disagreement
More children and adolescents are identifying as transgender and are being offered medical treatment, especially in the US—but some providers and European authorities are urging caution because of a lack of strong evidence. Jennifer Block reports

The NHS paid private hospitals £2bn in the pandemic: did taxpayers get value for money?
Private hospitals were paid around £2bn to help the NHS during the first year of the pandemic. Although they carried out millions of outpatient and diagnostic activities, some admitted few inpatients or used most of their beds to treat private patients. Esther Oxford reports

Big Macs and the Beano: Is it time for the comic to drop the junk food brands?
The Beano website describes itself as “100% safe for children”—but is its junk food related content doing more harm than good? Claire Mulrenan, Mark Petticrew, and Harry Wallop investigate

2022

FDA oversight of clinical trials is “grossly inadequate,” say experts
Covid-19 vaccines and drugs were developed at “warp speed” and now experts are concerned that the US Food and Drug Administration inspected too few clinical trial sites. Maryanne Demasi reports

FDA urged to publish follow-up studies on covid-19 vaccine safety signals
The FDA has been criticised for taking more than a year to follow up a potential increase in serious adverse events in elderly people receiving Pfizer’s covid-19 vaccine, Maryanne Demasi reports

The rise of direct-to-consumer testing: is the NHS paying the price?
Dozens of UK companies are offering private tests for a range of conditions and deficiencies. Some make claims that exceed the evidence base, and experts say regulation is needed to protect patients. Emma Wilkinson reports

Stealing from the tobacco playbook, fossil fuel companies pour money into elite American universities
Paul Thacker examines how oil and gas companies have funded research to try to weaken messages on climate change and protect their interests

Long covid patients travel abroad for expensive and experimental “blood washing”
Patients with long covid are travelling to private clinics in Cyprus, Germany, and Switzerland for blood filtering apheresis and anticoagulation drugs. Experts question whether these invasive treatments should be offered without sufficient evidence. Madlen Davies reports

From FDA to MHRA: are drug regulators for hire?
Patients and doctors expect drug regulators to provide an unbiased, rigorous assessment of investigational medicines before they hit the market. But do they have sufficient independence from the companies they are meant to regulate? Maryanne Demasi investigates

The black market for covid-19 antiviral drugs
Unequal distribution of covid-19 antivirals means patients are buying pills online that may not be safe when taken without medical supervision. Gabriel G Plata reports

Violent incidents at GP surgeries double in five years, BMJ investigation finds
The number of violent incidents at UK general practices recorded by police forces has almost doubled in the past five years, an investigation by The BMJ has found

Hundreds of patient data breaches are left unpunished
Pharmaceutical companies, NHS commissioners, and universities have repeatedly breached agreements around sharing patient data, audits show. Should NHS Digital curtail their access? Esther Oxford reports

Covid-19: Is the US compensation scheme for vaccine injuries fit for purpose?
Patients and lawyers say that America’s system for covid vaccine injury claims is costly, opaque, and yet to issue a single payout. Maryanne Demasi reports

Formula milk companies push allergy products despite flawed evidence
Europe has toughened its approach to formula milk products that claim to reduce allergy risks. But consumers elsewhere continue to be coaxed into buying products that make health claims without high quality evidence. Melanie Newman reports

Facebook versus the BMJ: when fact checking goes wrong
The BMJ has locked horns with Facebook and the gatekeepers of international fact checking after one of its investigations was wrongly labelled with “missing context” and censored on the world’s largest social network. Rebecca Coombes and Madlen Davies report

2021

Covid-19: Researcher blows the whistle on data integrity issues in Pfizer’s vaccine trial
Revelations of poor practices at a contract research company helping to carry out Pfizer’s pivotal covid-19 vaccine trial raise questions about data integrity and regulatory oversight. Paul D Thacker reports

Covid-19’s rebel scientists: has iSAGE been a success?
It turned a dozen scientists into media personalities, but what is Independent SAGE’s legacy, asks Laurie Clarke

Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US?
The US CDC estimates that SARS-CoV-2 has infected more than 100 million Americans, and evidence is mounting that natural immunity is at least as protective as vaccination. Yet public health leadership says everyone needs the vaccine. Jennifer Block investigates

Has the billion dollar crusade to eradicate polio come to an end?
The polio juggernaut, which has skidded past eradication deadline after deadline, seems to have finally run out of fuel, reports Robert Fortner

The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign?
The theory that SARS-CoV-2 may have originated in a lab was considered a debunked conspiracy theory, but some experts are revisiting it, Paul Thacker reports

Chronic fatigue syndrome and long covid: moving beyond the controversy
Many patients with “long” covid are experiencing extreme fatigue, a situation that has re-polarised approaches to treatment and rehabilitation. Melanie Newman reports

US college covid-19 vaccine mandates don’t consider immunity or pregnancy, and may run foul of the law
The requirement for vaccination with products under emergency use authorisation is new legal territory, finds Jennifer Block

Covid 19: How harm reduction advocates and the tobacco industry capitalised on the pandemic to promote nicotine
Scientific papers suggesting that smokers are less likely to fall ill with covid-19 are being discredited as links to the tobacco industry are revealed

Covid-19: How independent were the US and British vaccine advisory committees?
Experts who sit on national vaccine advisory panels are asked to disclose any industry ties and other conflicts of interest. But Paul D Thacker finds that disclosure standards differ widely

How Wellcome’s opaque fossil fuel investments harm its global health mission
Why does the Wellcome Trust continue to shun calls to divest while raising the status of climate change in its strategy? Tim Schwab reports

Covid-19 vaccines: In the rush for regulatory approval, do we need more data?
After rollout under emergency authorisation, manufacturers of covid-19 vaccines now have their sights on regulatory approval. But what’s the rush, asks Peter Doshi

Covid-19: Sputnik vaccine rockets, thanks to Lancet boost
Journals risk being used in place of regulators when they publish studies of novel vaccines that have not yet been authorised by a major regulator, argues Chris van Tulleken

Covid-19: Mass testing at UK universities is haphazard and unscientific, finds BMJ investigation
The rollout of lateral flow tests across campuses has slipped off the radar. How is it working, and what lessons can be learnt?

The EMA covid-19 data leak, and what it tells us about mRNA instability
Leaked documents show that some early commercial batches of Pfizer-BioNTech’s covid-19 vaccine had lower than expected levels of intact mRNA

Covid-19, trust, and Wellcome: how charity’s pharma investments overlap with its research efforts
The major funder of health research stands to gain financially from the pandemic, raising questions about transparency and accountability

Tracking down John Bell: how the case of the Oxford professor exposes a transparency crisis in government
Why won’t Oxford University or the government disclose the “long list” of financial interests of a high profile researcher

2020

Conflicts of interest among the UK government’s covid-19 advisers
Little is known about the interests of the doctors, scientists, and academics on whose advice the UK government relies to manage the pandemic, finds Paul D Thacker

Testing times for the government’s favoured antibody kit
The UK government has spent millions developing a rapid antibody test to help build up a picture of how the virus has spread across the country. But questions are now being raised over the test’s accuracy and an opaque procurement system that shuts competitors out, reports Stephen Armstrong

Will covid-19 vaccines save lives? Current trials aren’t designed to tell us
The world has bet the farm on vaccines as the solution to the pandemic, but the trials are not focused on answering the questions many might assume they are. Peter Doshi reports

From blockbuster to “nichebuster”: how a flawed legislation helped create a new profit model for the drug industry
Twenty years ago, the EU passed a law to motivate the drug industry to develop medicines for rare diseases. But a system intended to help patients turned into a corporate cash machine

Tobacco cash behind cannabis research in Oxford
A research collaboration that includes Oxford University is taking funding from the tobacco industry for research into the medicinal properties of cannabis

Big cannabis in the UK: is industry support for wider patient access motivated by promises of recreational market worth billions?
The BMJ has uncovered links between companies, campaign groups, and individuals lobbying for wider patient access to cannabis for medical use and a parallel campaign to create a lucrative recreational market for the drug in the UK

WHO’s malaria vaccine study represents a “serious breach of international ethical standards”
Experts are troubled by the apparent lack of informed consent in a large, cluster randomised study of the malaria vaccine. Peter Doshi reports

Are medical schools turning a blind eye to racism?
A BMJ investigation finds that medical schools are failing to monitor racial harassment and abuse of ethnic minority students. Zosia Kmietowicz reports

Specialty training: ethnic minority doctors’ reduced chance of being appointed is “unacceptable”
More than 25 years after two GPs uncovered bias in appointments to specialty training posts, new data show that the ethnicity gap persists, reports Gareth Iacobucci

Covid-19: Many trusts have not done risk assessments for ethnic minority staff
Some NHS trusts have been slow to act on calls to assess the increased risks associated with covid-19. Gareth Iacobucci finds out why

2019

US opioid prescribing: the federal government advisers with recent ties to big pharma
Tim Schwab investigates undisclosed competing interests at the influential National Academies of Science, Engineering and Medicine

The whistleblowing drama behind Astellas’s suspension from the ABPI
Deborah Cohen and colleagues reveal fresh claims about the treatment of an Astellas employee who offered to help it clean up its act

Leading ophthalmologist vows to stamp out “unjustified” screening for cataract surgery
NHS commissioners are ignoring clinical guidelines by rationing access to cataract surgery, an investigation by The BMJ finds

Big tobacco, the new politics, and the threat to public health
Jonathan Gornall reveals how The Institute of Economic Affairs is funded by British American Tobacco and has links with senior conservative ministers. After orchestrating a series of attacks on public health initiatives, the IEA may now hold the key to No 10

Questions over future of global diabetes group as founding members resign
While the numbers of people with diabetes worldwide soar, the organisation at the forefront of the global fight against the disease is tearing itself apart

Making China safe for Coke: how Coca-Cola shaped obesity science and policy in China
Susan Greenhalgh investigates how, faced with shrinking Western markets, the soft drink giant sought to secure sales and build its image in China

2018

How cow’s milk protein allergy is extending the reach of infant formula manufacturers
The condition may be helping the baby milk industry to form relationships with the paediatric profession, finds Chris van Tulleken—with potential for harm to mothers and children

What happens when the world’s biggest medical device maker becomes a “health services provider”?
A new cardiac suite with state-of-the-art equipment is developed for a cash strapped hospital in Mexico by the world’s leading medical device maker. What’s not to like? Jeanne Lenzer reports

How lobbying blocked European safety checks for dangerous medical implants
Industry lobbyists have wrecked plans to overhaul safety regulations for medical devices in Europe

Patients with type 1 diabetes are missing out on flash glucose devices
Tens of thousands of UK patients with type 1 diabetes are being denied the potential benefits of glucose monitoring devices because of a postcode lottery

How mesh became a four letter word
Jonathan Gornall charts the rapid rise and precipitous fall of vaginal mesh

The trial that launched millions of mesh implant procedures: did money compromise the outcome?
Jonathan Gornall uncovers how the original evidence on mesh was mired in a multimillion pound deal, industry funded research, and undisclosed conflicts of interest

Pandemrix vaccine: why was the public not told of early warning signs?
Eight years after the "swine flu" outbreak, a lawsuit has unearthed internal reports suggesting problems with the safety of GSK’s Pandemrix vaccine

Oxford TB vaccine study calls into question selective use of animal data
Researchers were disappointed when a clinical trial of a new tuberculosis vaccine failed to show benefit, but should it have gone ahead when animal studies had already raised doubts?

The pharma deals that CCGs fail to declare
GP commissioning groups have accepted hundreds of payments from drug companies that they have not disclosed to patients and the public

2017

The unofficial vaccine educators: are CDC funded non-profits sufficiently independent?
Peter Doshi investigates the semi-transparent world of vaccine advocacy organization

Are the odds shifting against pharma in the fight for cheaper treatment for macular degeneration?
Doctors plan to prescribe bevacizumab despite legal threats from drug companies, and against GMC and NICE guidance. Yet Deborah Cohen reports the tide may be turning

Big data’s big bias: bringing noise and conflicts to US drug regulation
A little known private foundation to support FDA’s “regulatory science” takes money out of the FDA’s coffers to support analyses using levels of evidence recommended by industry; many of the foundation’s directors have financial links to the drug and device makers that the FDA regulates. Jeanne Lenzer investigates

Coca-Cola’s secret influence on medical and science journalists
A series of journalism conferences on obesity received covert funding from Coca-Cola. Paul Thacker investigates

Is the United States Preventive Services Task Force still a voice of caution?
Recent recommendations issued by the USPSTF have surprised some experts who say they may lead to overtesting and overtreatment

2016

Manufacturer failed to disclose faulty device in rivaroxaban trial
An investigation by The BMJ finds that companies were aware of concerns about a faulty device in a regulatory trial and reveals data that suggests participants were put at unnecessary risk

A pill too hard to swallow: how the NHS is limiting access to high priced drugs
How NHS England tried to limit access to expensive new drugs for hepatitis C

Data too important to share: do those who control the data control the message?
Hydroxyethyl starch solutions for fluid resuscitation fell from grace after severe warnings about their safety. But the academic investigators that led a landmark trial that helped precipitate this downfall are refusing to share their data

Rivaroxaban: can we trust the evidence?
An investigation by The BMJ has uncovered the use of a faulty device in a regulatory drug trial, potentially putting patients at unnecessary risk

2015

India’s “health camps”: the drug rep will see you now
Pharmaceutical sales representatives are screening people in India in return for prescriptions for their products while calling it corporate social responsibility

General practice commissioning: in whose interests?
An investigation into England’s clinical commissioning groups shows that many are commissioning from organisations in which board members are involved

Public Health England’s troubled trail
The handling of evidence for its controversial report on e-cigarettes adds to questions about the credibility of the organisation’s advice

Tickets to Glyndebourne or the Oval? Big tobacco’s bid to woo parliamentarians
To what extent is the tobacco industry able to reach out and influence parliamentarians? Jonathan Gornall reports

Centers for Disease Control and Prevention: protecting the private good?
After revelations that the CDC is receiving some funding from industry, Jeanne Lenzer investigates how it might have affected the organisation’s decisions

Attacks on publicly funded trials: what happens when industry does not want to know the answer
Deborah Cohen reveals the challenges facing those conducting publicly funded clinical trials into the use of intravitreal bevacizumab

Why have UK doctors been deterred from prescribing Avastin?
Doctors in England’s NHS have been left seemingly unable to prescribe a cheap, safe, and effective drug despite its flourishing use elsewhere in Europe and the US

Sugar: spinning a web of influence
Public health scientists are involved with the food companies being blamed for the obesity crisis, reports Jonathan Gornall

Why aren’t the US Centers for Disease Control and Food and Drug Administration speaking with one voice on flu?
The CDC's claim that Tamiflu could "save lives" is at the center of a heated controversy

The truth about cash for referrals
Private hospital chains have been “buying” referrals by offering clinicians lucrative packages, including free facilities in sought after locations. And the doctors’ regulator is turning a blind eye to those who are tempted

2014

A third of NHS contracts awarded since health act have gone to private sector
In the run up to the UK general election, accusations are flying about the alleged privatisation of the NHS in England

Dabigatran: how the drug company withheld important analyses
Deborah Cohen finds that recommendations for use of new generation oral anticoagulants may be flawed because regulators did not see evidence showing that monitoring drug plasma levels could improve safety

GPs’ workload climbs as government austerity agenda bites
Since 2010 the UK government has brought in a raft of changes to the welfare system in a bid to reduce the national deficit

Under the influence
Jonathan Gornall discovers that the government consultation into introducing a minimum unit price for alcohol in England and Wales was a sham and that politicians ignored the strong health evidence in favour of protecting the interests of industry

The battle for NHS 111: who should run it now?
It all sounded so simple: a new phone number for urgent medical advice. But from its implementation the idea began to unravel

2013

Majority of panelists on controversial new cholesterol guideline have current or recent ties to drug manufacturers
Panelists of the working panel that wrote the controversial cholesterol guidelines on reducing cardiovascular risk had ties to the drug industry

A sixth of hospitals in England have expanded private patient options this year, the BMJ finds
As hospitals look for ways to boost their income, Gareth Iacobucci discovers that some are taking advantage of the rationing decisions being made by hard pressed clinical commissioning groups

Has pancreatic damage from glucagon suppressing diabetes drugs been underplayed?
A BMJ investigation has found growing safety concerns linked to incretin mimetics' mechanism of action

2012

How a fake hip showed up failings in European device regulation
Deborah Cohen investigates how EU authorities would be prepared to allow a fake hip prosthesis with dangerous design flaws onto the market

The truth about sports drinks
Deborah Cohen investigates the links between the sports drinks industry and academia that have helped market the science of hydration

How safe are metal-on-metal hip implants?
Deborah Cohen examines the evidence of risk from metal-on-metal hips, the manufacturers’ inadequate response, and how the regulatory bodies failed to give doctors and patients the information they need to make informed decisions

Search for evidence goes on
In the UK, general practitioners can now prescribe Oseltamivir it to anyone with flu and the drug is the mainstay of influenza treatment in critical care. How has this happened?

US advisory panellists on drug’s safety had ties to manufacturers
At least four members of a key committee advising the US Food and Drug Administration on the safety of a top selling drug have had financial ties to its manufacturers

2011

The Lancet’s two days to bury bad news
Brian Deer reveals what happened when he reported misconduct in Andrew Wakefield’s MMR research to the medical journal that published it

How the vaccine crisis was meant to make money
Brian Deer reveals a secret scheme to raise huge sums from a campaign, launched at a London medical school, that claimed links between MMR, autism, and bowel disease

How the case against the MMR vaccine was fixed
Brian Deer reveals a secret scheme to raise huge sums from a campaign, launched at a London medical school, that claimed links between MMR, autism, and bowel disease

2010

How small changes led to big profits for insulin manufacturers
Deborah Cohen and Philip Carter discover why more expensive analogue insulins are increasingly prescribed instead of cheaper human insulin despite lack of evidence of benefit for patients with type 2 diabetes

Rosiglitazone: what went wrong?
Over 10 years after the diabetes drug rosiglitazone was approved by regulators, and despite studies on tens of thousands of people, questions remain about its cardiovascular safety

WHO and the pandemic flu “conspiracies”
Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing

2004

FDA to review “missing” drug company documents
The US Food and Drug Administration has agreed to review confidential drug company documents that went missing during a controversial product liability suit more than 10 years ago

Documents missing from a 10 year old murder case sent to the BMJ
The BMJ has been given a set of documents that mysteriously went missing from a US mass murder case 10 years ago