Cost of open access publishing in otolaryngology‐head and neck surgery

Abstract

Objective

Open access (OA) publishing makes research more accessible but is associated with steep article processing charges (APCs). The study objective was to characterize the APCs of OA publishing in otolaryngology‐head and neck surgery (OHNS) journals.

Methods

We conducted a cross‐sectional analysis of published policies of 110 OHNS journals collated from three databases. The primary outcomes were the publishing model, APC for original research, and APC waiver policy.

Results

We identified 110 OHNS journals (57 fully OA, 47 hybrid, 2 subscription‐only, 4 unknown model). After excluding 12 journals (2 subscription‐only, 4 unknown model, 5 OA with unspecified APCs, and 1 OA that accepts publications only from society members), we analyzed 98 journals, 23 of which did not charge APCs. Among 75 journals with nonzero APCs, the mean and median APCs were $2452 and $2900 (interquartile range: $1082–3520). Twenty‐five journals (33.3%) offered APC subsidies for authors in low‐ and middle‐income countries (LMICs) and/or on a case‐by‐case basis. Eighty‐five and 25 journals were based in high‐income countries (HICs) and LMICs, respectively. The mean APC was higher among HIC journals than LMIC journals ($2606 vs. $958, p < 0.001).

Conclusion

APCs range from tens to thousands of dollars with limited waivers for authors in LMICs.

INTRODUCTION

With the rise of the Internet and the ease of electronic distribution of materials, open access (OA) has gained prominence in the scientific publishing industry to increase the availability of research and facilitate the exchange of scientific and clinical knowledge. The principles of OA include immediate and universal access to cutting-edge research, engagement of a broader audience, and flexibility for the authors to distribute and adapt their own work. Because OA journals do not receive payment from readers, they balance these costs by charging article processing charges (APCs) to the authors, their institutions, or their funders.

OA has been praised as a solution to democratize scientific knowledge and even the playing field for researchers in low- and middle-income countries (LMICs). In the traditional subscription-only scheme, most of the scientific literature remained inaccessible to individuals residing in LMICs. Proponents of OA argued that OA would finally close the knowledge gap between the Global North and Global South and accelerate scientific progress by increasing the productivity of LMIC researchers. In recognition of these benefits, Research4Life () initiated a program to provide researchers in LMICs with free or low-cost access to academic research. Publishers also began discounting or waiving the APCs for authors in LMICs to publish in OA journals using the Research4Life eligibility criteria, which are based on a country's United Nations Least Developed Countries designation and Gross National Income.

Despite its growth and benefits, OA has also drawn criticism. More recently, studies have highlighted the exorbitant costs of publishing OA. In analyses of cardiology/cardiac surgery and ophthalmology journals, the APCs ranged from hundreds to thousands of dollars. These high prices are especially concerning for researchers in LMICs whose countries are not covered by the publishers’ APC subsidy programs. For underfunded researchers who hope to avail themselves of the benefits of OA, these costs may drive them to find other ways to disseminate their research, perhaps in predatory journals that promise OA and more affordable pricing. Prominent OHNS journals have highlighted the issue and unethical practices of predatory journals in the field, but their number is unlikely to dwindle anytime soon.

In this paper, we undertook a close examination of OA publishing in OHNS. OA publishing costs have been studied in other surgical specialties, but they have not yet been examined in OHNS. We sought to evaluate the publishing models, APCs, and APC subsidy policies of OHNS journals.

MATERIALS AND METHODS

Using the Clarivate Journal Citation Reports in 2020, Scimago Journal Rankings, and Directory of Open Access Journals (DOAJ), we identified the journals listed under “Otorhinolaryngology” and included their sister journals. We excluded journals whose focus was beyond the scope of OHNS (e.g., study of the craniovertebral junction, health services research), defunct journals, and books. Based on the journal descriptions and the types of articles published, journals were categorized into one of the OHNS subspecialties (head and neck oncology, laryngology, otology/neurotology, rhinology, pediatrics, and sleep medicine). Journals without a single subspecialty focus were included in the “general” category.

For each journal, we collected the following information from its website: publishing model (OA, subscription-only, or hybrid), APC, and country of origin. We reported the maximum APC for the original research. All APCs listed were reported in US dollars (USD). Additionally, we noted whether a journal provided waivers and/or discounts for APCs. If the information about the APC or waivers was not explicitly shown on the website, we contacted the publisher or journal staff. The country of origin was mapped and dichotomized into the high-income country (HIC) versus LMIC, as defined by World Bank in 2022. As a secondary outcome, we also recorded whether a journal offered language-editing services in its author guidelines to capture additional costs that authors may incur during publishing. We used descriptive statistics (mean, median, range, interquartile range [IQR]) to characterize the APCs and compared the APCs between hybrid versus OA journals and HIC versus LMIC journals with the Wilcoxon Rank Sum test (p < 0.05 considered statistically significant). Stata (Ver 16.1, StataCorp LLC) was used for statistical analysis. University of California San Francisco Institutional Review Board approved this study as “Not Human Subjects Determination” (IRB 22-36433).

RESULTS

We identified a total of 110 nonduplicate OHNS journals from the three databases. Table  shows the characteristics of the included journals. Fifty-seven journals were fully OA (51.8%), 47 hybrid (42.7%), and two subscription-only (1.8%). The publishing model of four journals (3.6%) was unknown. By specialty, 61 were general (55.5%), 24 otology/neurotology (21.8%), 11 laryngology (10.0%), 7 rhinology (6.4%), 5 head and neck oncology (4.5%), 1 pediatrics (0.9%), and 1 sleep medicine (0.9%).

Table 1 Publishing models of included journals by subspecialty

Subspecialty	Hybrid [n (%)]	Open access [n (%)]	Subscription, [n (%)]	Unknown, [n (%)]	Total journals [N = 110, n (%)]
General	23 (37.7)	32 (52.5)	2 (3.3)	4 (6.6)	61 (55.5)
Otology/neurotology	11 (45.8)	13 (54.2)	0 (0)	0 (0)	24 (21.8)
Laryngology	6 (54.5)	5 (45.5)	0 (0)	0 (0)	11 (10)
Rhinology	3 (42.9)	4 (57.1)	0 (0)	0 (0)	7 (6.4)
Head and neck oncology	2 (40)	3 (60)	0 (0)	0 (0)	5 (4.5)
Pediatrics	1 (100)	0 (0)	0 (0)	0 (0)	1 (0.9)
Sleep medicine	1 (100)	0 (0)	0 (0)	0 (0)	1 (0.9)
Total	47 (42.7)	57 (51.8)	2 (1.8)	4 (3.6)	110

APC information was available for 98 journals after excluding 12 journals (2 subscription-only, 4 with unknown publishing models, 5 OA with unknown APCs, and 1 OA that accepted publications only from society members at no cost). Twenty-three journals (23.5%) did not charge APCs. The mean and median of nonzero APCs across 75 journals (47 hybrid, 28 OA) were $2452 and $2900 (IQR: $1082–3520), respectively. APCs were higher among hybrid journals than OA-only journals ($3316 vs. $1001, p < 0.0001) with a mean difference of $2314 (standard error: $202). Twenty-five journals (33.3%) offered waivers for authors in LMICs and/or on a case-by-case basis. APCs by subspecialty are shown in Table .

Table 2 Nonzero APCs by subspecialties

Subspecialty	APC (mean, USD)	APC (median, USD)	APC (interquartile range, USD)	Waivers offered [n (%)]
General (N = 38)	2381	2778	775–3520	13 (34.2)
Otology/neurotology (N = 18)	2471	2603	1500–3530	6 (33.3)
Laryngology (N = 7)	2709	3085	2000–3400	1 (14.3)
Rhinology (N = 7)	1883	1600	800–3600	4 (57.1)
Head and neck oncology (N = 3)	3427	3390	2490–4400	1 (33.3)
Pediatrics (N = 1)	3140	3140	N/A	0 (0)
Sleep medicine (N = 1)	3390	3390	N/A	0 (0)
Total (N = 75)	2452	2900	1082–3520	25 (33.3)

Among 51 OA-only journals, 39 (76.5%) and 28 journals (54.9%) were included in the DOAJ and required APCs, respectively. Similar rates of DOAJ-accepted journals and non-DOAJ-accepted journals charged nonzero APCs (53.8% vs. 58.3%, p > 0.05). APC did not statistically differ between DOAJ-included journals and non-DOAJ-included journals ($1091 vs. $733, p > 0.05) with a mean difference of $357 (standard error: $156).

Table  shows the APCs by income grouping of the country of origin. Of the 110 journals, 85 (77.3%) and 25 (22.7%) were based in HICs and LMICs, respectively. Thirty-four HIC journals (40%) were fully OA; 23 LMIC journals (92%) were fully OA. While 68 (80%) of the HIC journals charged an APC, only 7 (35%) of the LMIC journals charged an APC. The mean and median of APCs of all HIC journals with nonzero APCs were $2606 and $2935 (IQR: $1550–3530). The mean and median of APCs of all LMIC journals with nonzero APCs were $958 and $300 (IQR: $110–2305). APC was significantly higher among HIC journals than LMIC journals (p = 0.0005) with a mean difference of $1648 (standard error: 528). Fifty-nine of the 110 journals (53 HIC journals, 6 LMIC journals) advertised English language editing services outside of the APC.

Table 3 APCs by high-income country journals versus low- and middle-income country journals

Country of origin	APC (mean, USD)	APC (median, USD)	APC (interquartile range, USD)	Waivers offered [n/N (%)]
High-income countries journals	2606	2935	1550–3530	24/68 (35.3)
Low- and middle-income countries journals	958	300	110–2305	1/7 (14.3)

DISCUSSION

OA publishing is widely available in OHNS, in either hybrid or OA journals. Among the 98 journals with available APC information, 76.5% charged APCs to authors. The mean APC across 75 OHNS journals with nonzero APCs was $2452, with waivers and discounts offered by only 33.3% of the journals. The APCs of hybrid journals were significantly higher than those of OA-only journals. The APCs of HIC journals were also significantly more expensive than those of LMIC journals, 65% of which did not require APCs compared to 20% of HIC journals. The mean APC among OHNS journals was slightly cheaper than in other specialties.

Although publishers of some HIC journals offer waivers to authors in LMICs, the costs remain high for many LMIC researchers. The journals’ narrow definition of countries eligible for APC subsidies leaves many in the “upper-middle-income trap,” in which researchers have neither the funding to pay nor the exemption from APCs. Furthermore, some journals stipulate that all authors of a publication must reside in LMICs to qualify for the waiver, which may discourage or disrupt collaboration between HIC and LMIC researchers. While many journals offer a case-by-case waiver, the standards of these exceptions are opaque, and the success rates of such appeals are unknown. Because our data derives from waiver policies published on journal websites, we have limited insight into the criteria and potential coverage of these case-by-case waivers. Journals can potentially vary widely in their flexibility and accommodativeness of the case-by-case waivers; they can make this process more transparent by publicizing specific considerations and qualifications for such waivers.

Nabyonga-Orem et al. demonstrated that researchers in some African countries will have to sacrifice 6 months’ salary to pay an APC of $2600 out of pocket. This finding correlates with research showing that individuals from countries with gross domestic products (GDPs) lower than $25,000 are likelier to pay APCs out of pocket than their counterparts from countries with GDPs higher than $25,000. In contrast to LMICs, researchers in HICs have institutional funding or grants that support OA. Without sufficient funds, individuals are left with two choices. The first is to publish their article via the subscription model, which would cost nothing but may prevent their local colleagues from accessing the research from which they could learn and benefit. The second option is to publish in a more affordable journal. Facing financial barriers and professional pressures to publish, researchers may become susceptible to predatory journals, which send out mass generic email invitations to submit an article with promises of rapid review and OA and later extract smaller but nonetheless additive charges. On top of the APCs, authors with limited English proficiency may have to pay for language-editing services. Surveys of researchers in LMICs revealed that many have had to pay for language editing or translation services, which cost hundreds of dollars.

The burden of otolaryngologic disease, such as head and neck cancer and hearing loss, is substantial in LMICs. Building research capacity to promote and advance patient care in LMICs is key to solving the complicated issues around OHNS disease in these regions. However, the prices of the pay-to-publish OA model may hamper research dissemination in LMICs and may exacerbate the global inequities of knowledge within the field.

Publishers must expand the scope of full and partial waivers offered to authors in LMICs. An executive at a well-known OA publisher revealed that it costs $290 for his group to publish one article. Fagan successfully self-published two OA OHNS textbooks at zero cost, further confirming the feasibility of affordable OA publishing. These accounts suggest that it is feasible to publish OA articles at a much lower cost than what many journals charge and poses a question of where the bulk of the APC goes, even after accounting for the administrative and miscellaneous costs in academic publishing. To remove yet another barrier for nonnative English speakers, many of whom are in LMICs, publishers can extend their waivers and subsidies to language editing services. Several journals offer free OA publishing through partnerships with professional societies and governments, which represents a promising model of publishing that can maximize article dissemination at no expense to authors.

There were several limitations to this investigation. We focused on only journals dedicated to OHNS, excluding related specialties, such as dentistry, plastic surgery, and oral and maxillofacial surgery. We also chose three well-known and often cited databases, which may not have included all journals. Furthermore, journals offered discounted APCs if the author was a member of their affiliated societies, or if the submission was transferred from another journal. While we did not account for this variability, these discounts were offered by only a few of the included journals.

CONCLUSIONS

To our knowledge, this is the first study to examine the practices and costs of OA publishing in OHNS journals. Most journals provide OA publishing opportunities, but APCs of OA publishing are high. Journals based in HICs charge significantly higher APCs than their counterparts based in LMICs, which may disproportionately affect underfunded researchers and may hamper research capacity building in LMICs. Future works should directly examine how APCs may affect research dissemination among researchers in underfunded settings.

AUTHOR CONTRIBUTIONS

Eric K. Kim: Conception, design, data collection, data analysis, manuscript writing, and approval. Mark G. Shrime: Conception, design, data analysis, manuscript writing, revision, and approval.

ACKNOWLEDGMENT

The authors received no grant or funding for this work.

CONFLICT OF INTEREST

Dr. Shrime receives funding from the Iris O'Brien Foundation and is on the board of Pharos Global Health Advisors.

DATA AVAILABILITY STATEMENT

Study data were collected by querying the journal websites and/or contacting the editorial offices.

ETHICS STATEMENT

University of California San Francisco Institutional Review Board approved this study as “Not Human Subjects Determination” (IRB 22-36433).

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