Over the years, payments have soared to thousands of pounds per completed patient, and well- organised British general practices can earn an extra 15,000 annually for three hours' work a week, write the authors. As a result, trials designed by non-commercial sponsors aiming to answer clinically important questions, but without the funding available to pay recruiters, fail to attract doctors.

Although guidelines insist that such payments are divulged to a research ethics committee, commercial sponsors regularly flout these recommendations, they add.

Patients believe that such payments are wrong and that they have a right to be told about them, say the authors. Furthermore, a change to the regulatory framework making full disclosure mandatory would not meet with opposition.

"Consent obtained on the basis of withholding information on an issue that patients consider important is not fully informed consent. If we are ever to reach the ideal of involving patients in the design and conduct of clinical trials then we could do worse than treat patients as equal partners by making full and frank disclosure of payments that trial sponsors make to doctors for recruiting their patients," they conclude.

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Contact: Emma Wilkinson
ewilkinson@bmj.com
44-20-7383-6529
BMJ-British Medical Journal
4-Jul-2002