The International Society for Medical Publication Professionals (ISMPP)’s first white paper, ‘A multistakeholder discussion on open access and medical publishing’, was announced at the 15^th Annual Meeting of ISMPP. As described in a recent article for the MAP newsletter, the white paper examines the evolution of open access (OA) publishing and its implications for publishers, funders, industry, learned societies, academic authors and patients.

The paper outlines that OA publishing now encompasses a range of options (gold, green, bronze, platinum), differing in restrictions on data reuse and publishing costs for the author (or their institution/funder) through an article processing charge (APC). Over recent decades, research output has increased drastically, putting pressure on publishing processes and escalating publishers’ expenses. As rising costs have been passed on to research institutions through journal subscriptions, and the sum of APCs has increased as more research is published OA, institutions have become less willing to pay subscription fees. This is likely to result in changes in funding models for medical publishers, regardless of OA regulations.

However, under Plan S, full and immediate open access will become a requirement for publications reporting work funded by cOAlition S supporters. In this context, the paper’s authors argue that production costs will increase dramatically for journals with a high volume of submissions, as only published articles generate APC revenue –  Nature estimates that their publishing costs are up to $40,000 per published paper. Some have suggested that increased costs could be ameliorated by a move to a submission charge, per the F1000Research model. The white paper reports that learned societies point out that making their journals fully OA erodes a member benefit – and could result in fewer members, higher membership fees or service cuts. They cite a diversified publishing model (including hybrid or mirror journals, both to be barred under Plan S) as essential to sustain lossmaking or ‘break-even’ OA society journals, for which rigorous peer review processes incur significant costs. From another perspective, not-for-profit funders suggest that mandatory OA would boost access for researchers at poorer institutions, although publishers point out that access challenges in low- and middle-income countries are often related to infrastructure rather than journals: for example, the existing Research4Life organisation provides free- or low-cost online access to publications.

The paper further reports that the OA mandate under Plan S could restrict authors’ choice of journals, which some perceive as conflicting with good publication practice and guidelines, constraining academic freedom, and risking collaborations between cOAlition S- and non-cOAlition S-adhering countries. For academic authors, while OA articles are cited more often, current hiring and grant evaluation methods promote publication in high impact journals (many of which are not Plan S-compliant) over OA considerations. However, there would be fewer barriers to obtaining research to include in systematic reviews. For patients, mandatory OA is welcomed as paywalls represent a significant obstacle to accessing information.

For gold OA, the type of Creative Commons licence used is important, since this dictates reuse rights. The CC BY licence, allowing any reader to distribute, adapt, and build upon work as long as they credit the original author, is the minimum requirement under Plan S. However, the paper’s authors fear that funders’ conflicting requirements may pose an administrative burden, despite policy alignment being a principle of Plan S. Industry stakeholders point out that while they support the ethical arguments for OA, regulations do not always permit the same OA options as for noncommercial funders – many journals disallow use of a CC BY licence for industry-funded research – and this could make industry members less desirable as collaborators. Learned societies highlight the potential for content to be misused under the CC BY licence, risking author reputations and distribution of health misinformation. Requiring use of a CC BY licence is also argued to impact publishers’ finances, as reprint revenues will fall.

Perhaps the future publication landscape will be more nuanced than the current Plan S vision. David Sampson (Vice President, Journals & Publishing, American Society of Clinical Oncology) envisages continued growth of OA, but through a combination of full OA journals, hybrid journals and platforms eschewing traditional publishing workflows. Sampson suggests that public access to the literature could be enabled through schools and public libraries, citing the example of Access to Research in the UK.

The debate surrounding mandatory OA policies certainly continues, and many stakeholder perspectives must be considered if we are to create a sustainable publishing environment fit for the future.

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Summary by Beatrice Tyrrell DPhil from Aspire Scientific

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