Figure reuse: Copyright permissions and Creative Commons
Have you worked on a medcomms project and used the phrase “Adapted from…”? Then you’ve likely come across the question ‘do I need copyright permissions to reuse this figure?’
And if you haven’t, you’ll inevitably find yourself asking that question when you work on a sales aid, direct mailer, educational or training slide decks and even in publications.
Did you know that tables from scientific articles are also subject to copyright?
My most frequent encounter with copyright issues/queries is working on training materials (whether that be for pharma internal teams or for healthcare professionals) and also workshops/symposia slide deck presentations. You know, the typical first slide is often a nice-looking figure of disease pathophysiology, or in the middle of your presentation you have a disease management algorithm, or even later on a key efficacy figure or safety table about an investigational drug.
I’ve also come across copyright queries when designing an eDM notifying healthcare professionals of a new article that’s been published.
But here’s some basic context before tackling figure/table reuse (or distributing copies of the publication) in our line of work.
What is copyright?
Let’s just get this question out of the way first. Copyright is a type of intellectual property law that gives its owner the exclusive right to use a piece of original work. It can apply to a whole bunch of things, including paintings, photos, illustrations, music compositions, books, and movies.
Some things that are not subject to copyright include ideas, facts and data.
In the medcomms world, copyright applies to the scientific publications Medical Writers help support. If you’ve worked on medical publications, congress presentations, marketing or promotional materials, websites or medical education, you’ve probably asked yourself whether you need copyright permissions for reusing a piece of work from a published article (or perhaps even some stock photography).
By this we mean reusing figures or tables within a journal article (e.g. in an educational slide deck) or even the publication themselves (e.g. distributing hard or soft copies). These all represent the author’s work — and you guessed it — subject to copyright.
Here are the top 10 misconceptions about copyright in medical communications developed by the CCC. It addresses things like ‘I can share a publication without permission and won’t get into trouble’ or ‘I’ve ordered article reprints, so I can also distribute electronically’. I’m certain that you’ll have ‘misconcepted’ one (or more) of these before.
In medical publications, you may have innocently checked a box that says you (on behalf of the corresponding author) will sign over the rights of a scientific manuscript over to the journal’s publisher during the submission process.
This is known as the copyright transfer agreement. When they sign this, they’re essentially allowing the publisher to do ‘pretty much whatever’ they want with the authors’ published article. Broadly speaking, they can publish and make derivatives of your work in any print or digital format.
I want to reuse a figure/table from a published article
So you’re preparing an educational slide deck for a client and you want to use a lovely illustrated figure from a comprehensive disease overview article that took a graphic designer hours to perfect?
Do you think by solely giving credit and citing the original reference is enough — the famous line ‘Adapted from Smith J et al. 2024’?
The answer is almost always no.
Although the authors of the original article created this lovely figure, they had signed over the rights and permissions to use it (or for you to ‘reuse’ it) to the publisher (e.g. Elsevier, Taylor & Francis, Wiley, Springer Nature, SAGE etc.). If you want proper permissions to reuse this figure, you basically need to pay a hefty fee for its permission.
Elsevier has put together a fairly detailed FAQ on copyright permissions that you should bookmark on your browser.
Having said that, applying for permissions is easier than ever, much like ordering food on your Uber eats app.
On the journal article’s webpage, you’re looking for the © symbol, or perhaps the word “Permissions”. Clicking on that takes you to a licensing and content solutions service. The most common one that I’ve encountered is ‘RightsLink’ from the Copyright Clearance Center (CCC).
In the following example, I’ve randomly used an article from the New Engl J Med journal and snapped a few screenshots of this RightsLink service to show you the information you’ll need to reuse a figure in your educational slide deck.
Basically to get permissions, you’ll need to know the purpose of reusing the copyrighted piece of work, who’s applying for it, what part of the article you wish to reuse, how will it be presented, what’s the type of activity it will be used for, 7) audience size, etc.
The information and options available vary slightly from publisher to publisher, and even article to article. So, make sure you have the answers to these questions before applying for permissions.
Knowing these early can help secure/facilitate any budget or proposal discussions with the client, so try to think ahead.
I do not want to pay for rights and permissions to reuse a figure/table
Now here’s where it can get interesting, with a little bit of creativity — open access publications! We know open access means that readers can freely read a published article, so it’s not behind a paywall for subscribers only (or that only uni students can access). To have an article published as open access, authors generally have to pay a fee (i.e. article processing charge, or APC) after the acceptance of their manuscript.
Now, don’t mistake open access as a means for freely taking a copyrighted figure and freely using it in your (for example) symposium slide deck — although in some instances this may be the case, but more on that below. Open access publications are still protected by copyright, but they are additionally published under a set of Creative Commons (CC) licenses.
So now I ask the same question – do you think by solely giving credit and citing the original reference is enough for reusing a figure? This time, the answer is, it depends. It depends on the CC licence that open access article was published under.
Here’s another situation where you don’t need permissions – when you summarize data from a publication or use published data to create a new figure/table. So inventing something, so to speak, and then ‘copyrighting’ it yourself…
You will typically find this information on the article page on the journal’s website and sometimes on the PDF file as well. You’ll be looking for a couple of letters: CC BY or variations thereof. Here’s some brief definitions of the ones you’ll most likely come across:
- CC BY: reuse (distribute, adapt, build upon) is permitted, even for commercial purposes, as long as you credit the owner.
- CC BY-NC: reuse (distribute, adapt, build upon) is permitted for noncommercial purposes only, and you’ll need to credit the owner.
- CC BY-NC-ND: reuse (copy and distribute the ‘unmodified’ content, i.e. no derivatives allowed) is permitted for noncommercial purposes only, and you’ll need to credit the owner.
Again, to properly request permissions for reusing a figure in your symposium slide deck, you can click on the © symbol or Permissions button and you go through the same process via RightsLink to see whether you need to pay a fee.
If you’re lucky and the article is published under a ‘less restrictive’ CC BY licence, then you should be able to reuse and redraw the figure into your fancy brand colours, and all you need to do is credit the owner. Some journals will tell you what you’re allowed and not allowed to do, and here are some screengrabs that I’ve come across in my publications career chapter. You can usually find these under ‘Article information’.
Some tips for reusing ‘some’ figures
If you’re after some disease pathophysiology figures or cellular signalling pathway figures, you might be in luck.
Head over to PubMed Central and go to the advanced search function. Select ‘Filter’ from the drop-down list and click ‘Show index list’. Scroll down to “cc by license” and you’ll see there’s about 4 million articles published under the least restrictive CC BY license. If you combine this with a couple of key words, you should hopefully, find an article with a similar figure that you can ‘freely’ reuse.
Obviously, key efficacy and safety results about a drug will only be available from the pivotal publications, which may be published as open access and may allow reuse. It’s worth noting that some journals may not allow reuse of industry sponsored publications for commercial purposes.
You can see how the purpose of reuse is an important factor (educational vs promotional) and may very well dictate whether you can reuse it or not.
Here’s an ISMPP newsletter that talks a bit more about CC licenses and how pharma should carefully consider the type of CC license they should publish their clinical trial data, as it can have long-term implications and costs for reusing ‘their-own-but-unfortunately-copyrighted’ materials.
How about creating your own figures?
The thought of creating your own professional-looking disease mechanism figures can be daunting for some Medical Writers. And we all know the limits of the shapes and things in Microsoft PowerPoint.
Ever heard of Biorender? It’s an inexpensive online service that anyone without medical illustration design knowledge (like myself) to effortlessly put together a professional-looking scientific figure. Check out their website here: https://www.biorender.com/
I probably wouldn’t ask generative AI tools like Microsoft Copilot, Midjourney, DALL-E to create these highly technical figures. Not at this point in time anyways.
What’s another area in Medical Writing that has you up half the time you’re waiting to fall asleep at night? Note some down in the comments.
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Abbreviations: AI, artificial intelligence; APC, article processing charge; CC, Creative Commons; CC BY, Creative Commons Attribution licence; CCC, Copyright Clearance Center; eDM, electronic direct mailer; ISMPP, International Society of Medical Publication Professionals.
