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In Full Bloom: A Closer Look at Open-Access Publishing

March 22, 2024

April 2024

Naseema Gangat, MBBS, is a professor of medicine in the Division of Hematology at Mayo Clinic in Rochester, Minnesota.Naseema Gangat, MBBS, is a professor of medicine in the Division of Hematology at Mayo Clinic in Rochester, Minnesota.




In the last two decades, open-access publishing has become mainstream and is now like a rose in full bloom within the scientific world. Like Queen Mary’s Garden in London’s Regent’s Park, which boasts about 12,000 roses and is free of charge, the number of open-access journals that provide free online content to readers has blossomed to more than 20,000.1

Roses at Queen Mary’s Garden in Regent’s Park, London.
Roses at Queen Mary’s Garden in
Regent’s Park, London.

In the U.S., there have been increasing requirements for open-access research going as far back as 2008 when the National Institutes of Health mandated that federally funded research be made publicly available in the PubMed central repository within 12 months of publication. Most recently, in 2022, the White House announced that by the end of 2025, all taxpayer-funded research must be made open access immediately upon publication.2 In 2018, Coalition S, a similar European initiative, was unveiled with an additional requirement that publishers give up copyright.3 In other words, research funded by public or private grants must be published in open-access journals or platforms or be made immediately available through open-access repositories without embargo.

To help better understand the current state of open-access publishing, throughout this column I provide a refresher on the open-access lexicon, followed by a discussion on the pros and cons of this publishing model.

Variegated Access

In the open-access journal model, all articles are available online at no cost to the reader, while authors, funders, or institutions pay an article processing charge (APC) for publication. Alternatively, hybrid journals are traditional subscription journals that provide authors with the option to make articles open access by paying APCs.

An additional avenue for free access is through preprint servers and platforms, which house an early version of a research article that has not been peer reviewed but is published immediately with a citable digital object identifier (DOI). Although increasingly recognized and used during the COVID-19 pandemic, preprint platforms have existed for more than three decades — arXiv has covered the physical sciences since 1991, in addition to bioRxiv and medRxiv, which were launched by Cold Spring Harbor Laboratory for biological and health sciences in 2013 and 2019, respectively.

In the same vein, research articles are designated as “gold” open access when made immediately available to readers without charge or restrictions, while authors are subject to APCs. Typically, gold open-access articles are published under a Creative Commons license (CC BY license), which enables readers to alter and redistribute the material, provided the authors are credited for their original work. “Green” open access refers to self-archiving by authors in a central repository or preprint server following an embargo period (about 6 to 12 months) that is specified by the publisher. Rarely, articles are “diamond” open access, in which they’re made freely available with no cost to readers or authors; typically, these are funded by academic institutions, societies, or donors. Finally, in “bronze” open access, which is not truly open access, articles are free to read and download without incurring charges to the author; however, because these articles are not formally licensed for sharing or reuse, access may be revoked by the publisher at any time.

Roses and Thorns

Undoubtedly, open access enables the timely dissemination of research to the scientific community and public. Its overarching benefits, including wider impact, greater visibility, and the potential to accelerate scientific discoveries and promote diversity and equity through global access to research findings, cannot be overemphasized. Not surprisingly, between 2012 and 2022, the number of subscription-only articles declined from 61% to 47%, which was attributed to a proportionate increase in gold open-access articles published in the U.S.4 However, a big thorn in the open-access world is the APC, which can range from an outrageous $11,690 for Nature Medicine, to $2,300 for Cancer Discovery, which is in addition to a base publication fee of $4,900.

Because the pay-to-publish model is a major hindrance for researchers in developing countries, some journals, such as those published by the American Society of Hematology and the American Association for Cancer Research, provide country-specific discounts on publication fees to support research from low-income communities. Nonetheless, this fails to address other possible research inequities, because early-career investigators from first-world countries with limited institutional or federal funding may not qualify for an APC waiver.

Budding Concerns

Will open access be sustainable in academic publishing? In an effort toward equity with respect to readership, the cost of APCs remains an ongoing challenge. Furthermore, the momentous growth in preprints and predatory open-access journals has instilled concerns about research credibility in the absence of rigorous peer review and hesitancy on the part of some researchers to publish in open-access journals. In this regard, BioMed Central and PLOS were the pioneers of open-access journals, and several reputable journals have followed by providing gold or hybrid open-access options, while still conforming to high standards of peer review.

It should be noted that the highly esteemed New England Journal of Medicine does not use a pay-to-publish model, and full texts of all research articles are made available free of charge on its website six months after publication in print.

Regardless, several questions about the future of open access remain unaddressed, and with all of its benefits and drawbacks, I can’t help but think of the adage, “From a thorn comes a rose, and from a rose, a thorn.”

Naseema Gangat, MBBS
Associate Editor


  1. Directory of Open Access Journals. Homepage. Accessed January 26, 2024.
  2. Tollefson J, Van Noorden, R. US government reveals big changes to open-access policy. Nature. August 26, 2022. Accessed January 26, 2024.
  3. Else, H. A guide to Plan S: the open-access initiative shaking up science publishing. Nature. April 8, 2021. Accessed January 26, 2024.
  4. Open access uptake by countries/regions. Accessed January 26, 2024.

The content of the Editor’s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated.

Have a comment about this editorial? Let us know what you think; we welcome your feedback. Email the editor your response, along with your full name and professional affiliation if you’d like us to consider publishing it, at



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