Pharmaceutical companies fund a substantial portion of biomedical research that directly influences disease understanding, treatment decisions and public health. The authors argue there is an ethical obligation to make research conducted in human participants freely and universally accessible regardless of funding source. International frameworks support this duty: the World Medical Association Declaration of Helsinki recognizes an ethical duty to make research results public, and WHO and UNESCO initiatives promote universal access to reliable health information and open science principles including transparency and sharing of knowledge and data.
Ensuring access to peer-reviewed clinical research aligns with these ethical and policy foundations because it supports transparency, reproducibility and public trust in science.
Paywalls are a minor budgetary inconvenience for some well-resourced institutions but present substantial barriers for many stakeholders. Healthcare professionals, researchers, guideline developers, policymakers, and others working outside academic institutions can lack access to full-text articles. This disproportionately affects individuals and institutions in low- and middle-income countries and clinicians in community settings.
Restricted access can limit the ability to evaluate, validate and synthesize the full body of evidence, undermining evidence-based medicine. Patients, caregivers and members of the public may also lack direct access to peer-reviewed findings, including volunteers in clinical trials. Limited access may drive people toward less reliable information sources and increase exposure to misinformation. The authors note that access is increasingly important in an information environment dependent on artificial intelligence systems that rely on broadly available evidence.
Many pharmaceutical companies now commit to publishing medically important trial results in reputable peer-reviewed journals and are willing to cover open access fees. Despite these commitments, a number of high-impact journals do not offer the same open access options to commercial funders that they offer to noncommercial funders. Some journals permit green open access (self-archiving of the accepted author manuscript) but continue to restrict the published, peer-reviewed version of record behind paywalls.
Preprints provide an avenue for early dissemination but are not considered substitutes for the version of record, which is essential for validated scientific communication and for inclusion in clinical and policy decision-making.
The Open Science movement has roots in a not-for-profit ethos and there is historical skepticism toward for-profit research, sometimes justified by documented cases where commercial interests influenced design, interpretation, publication practices or research independence. This history contributes to restrictive journal policies that treat company-funded research differently.
However, the authors emphasize that conflict of interest concerns do not inherently invalidate research. Integrity is strengthened through transparent disclosures, rigorous peer review, data sharing and independent scrutiny. They argue that research meeting rigorous, ethical and transparent standards should be judged on its merits rather than its funding source.
The concentration of academic publishing within a small number of major commercial players can create incentives to protect subscription revenue. The authors highlight a paradox: noncommercial funders' success in requiring open access may encourage publishers to continue paywalling commercially funded research to protect subscriptions.
This pattern can mean that the most clinically relevant research remains less accessible. Limited access undermines the global utility of scientific findings as public goods and can impede the ability of clinicians, guideline developers and policymakers to apply the best available evidence to patient care and public health decisions.
The authors call for new publication models that grant authors of commercially funded research the same rights as other authors to publish open access in high-quality peer-reviewed journals while sustaining rigorous peer review and guarding against predatory publishing. Transformative agreements—used by academic institutions to combine subscription fees and article processing charges—are proposed as one mechanism that could be extended to allow pharmaceutical companies to expand open access publishing without restricting authors' journal choice.
They also urge publishers to adopt funder-neutral open access policies and to clarify positions on self-archiving of the version of record so that company-funded clinical research can be free to read and reuse from the date of publication.
The perspective urges pharmaceutical companies and publishers to collaborate on creative solutions that balance the needs of all stakeholders and protect the integrity of peer review. Specifically, the authors implore publishers to introduce funder-neutral open access policies and clearer rules on self-archiving of the version of record to ensure company-funded clinical research is universally accessible.
They argue that achieving equitable open access will enhance transparency, support collaborative scientific dialogue and produce public health benefits by making validated clinical evidence available to everyone who needs it.
(References and acknowledgments were reported in the source. Funding and competing interests are declared by the authors in the original article.)