Are Advertising Trackers a Conflicted Interest for Medical Journals?

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We’ve all been there: Searching online for something to buy, deciding not to, and then having the item stalk us as we move from site to site. (It doesn’t even disappear if we purchase it.) Advertising tracking has been accepted as the price for a “free” Internet, but a new study shows that ad tracking from Big Pharma is alive and well in medical journals. We shouldn’t be surprised.

The researchers identified 1605 journals with an impact factor greater than 2. An impact factor is an advertising metric, too – it tells you how often articles have been cited from a specific journal [1]. Those numbers change annually. They then went to the journal’s home page and identified

  • Third-party data requests – that provide those parties with information on the computer in use
  • Third-party cookies – data left behind on the computer that enables tracking across the web

They found that 99% of these journals’ home pages had third-party data requests, not just a few, a median of 31. For those looking for solace, those higher impact journals like NEJM or JAMA, or the Lancet, held to a higher standard with fewer data requests, only 19.

Only 77% of journals left behind those cookies meant more as a third-party treat than something for us. The median number of cookies was 8, and the impact factor had no role here.

Who were the big third parties? The top ones were not Big Pharma; they were social media and data aggregators (Google, Oracle, and Adobe). They go on to sell that information to their subscribers. All five sell to Big Pharma.  

Who Gains?

The journals, I am sure, would be the first to tell you that these trackers help their subscribers. After all, wouldn’t you want to be reminded of a new therapeutic option after reading the results of a clinical trial? Doctors are busy; this is just a value-added service.

Journals might also mention that it improves their bottom line – they are not charitable organizations; they have a profit margin of 28 to 39% on each dollar of revenue, at least in 2011. It allows for targeted advertising by pharmaceutical and device companies without question, giving them more bang for their buck.

Suppose ProPublica and other organizations are correct that just the hint of advertising and a free lunch can significantly alter the prescriptions written by physicians. Shouldn’t we be as concerned, if not more so, with these trackers? Is it time to make medical journals safe spaces – free of ways to monetize, for others, our interests and concerns?


[1] The Impact factor is the number of citations received in the current year to articles published in the two preceding years divided by the number of articles published in the same two years.






Source: Prevalence of Third-party Tracking on Medical Journal Websites JAMA Health Forum DOI: 10.1001/jamahealthforum.2022.0167