B – Head-to-head RCTs and industry sponsor

Flacco ME, Manzoli L, Boccia S, et al. Head-to-head randomized trials are mostly industry sponsored and almost always favor the industry sponsor. Journal of Clinical Epidemiology 2015;68(7):811-820
(doi: 10.1016/j.jclinepi.2014.12.016)

To map the current status of head-to-head comparative evidence, the authors analyzed a large sample of recently published head-to-head randomized clinical trials (RCTs) covering a wide range of clinical conditions. They evaluated trials with at least 100 participants and specifically focused on the sponsoring of these trials. The literature of head-to-head RCTs is dominated by the industry. Industry-sponsored comparative assessments systematically yield favorable results for the sponsors, even more so when noninferiority designs are involved.