Without a mandatory registration system, the companies would still have it in their interest to not publish certain trials.
Science and Nature should take the lead in the wake of this scandal. In a world where financial incentives can warp the scientific enterprise just as much as the lust for scientific prestige, it is incumbent that journal editors have strict conflict-of-interest disclosure policies. And, given the voluntary nature of disclosure, they should have teeth like a three-year ban on publishing for failing to disclose.
The public's faith in the integrity of the process is undermined when one-third of an advisory committee's membership has significant financial ties to the company seeking the product's approval.
One could imagine prizes in the billions of dollars based on considerations such as the prevalence and public health impact of the disease, the difficulty in developing its cure, and the capital investment required to achieve results.
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