Thursday, May 05, 2005

Plugs for Drugs 

James Ridgeway on the increasingly fuzzy distinction between medical research and advertising:
Everyone knows that the big pharmaceutical companies finance the research that is then fobbed off on the compliant Food and Drug Administration as independent, dispassionate examination of new drugs. But what isn't so widely known is that the very articles written to support an existing drug or pave the way for introduction of a new drug—articles signed by the most reputable of experts—are ghostwritten.

Pharmaceutical firms engage intermediary companies to ghostwrite reports and then round up well-known names to sign them. The people signing these articles had nothing to do with the research that stands behind them and did not even have a hand in composing the articles they are signing.
Ridgeway cites the case of Adriane Fugh-Berman of Georgetown University, who was handed a 2,848-word manuscript under her own byline, ready for submission to an academic journal. (The ms., prepared by a company called RxComms, highlighted problems with an existing anticoagulant drug; it had been commissioned by the pharmaceutical firm AstraZeneca, which was about to release a competing product.) Fugh-Berman, however, refused to play along:
I declined the offer from RxComms, but another "author" was willing to do it. A few weeks later, a manuscript with alarming similarities was sent to me for peer review by the Journal of General Internal Medicine. On being told I believed that the paper was ghostwritten, the journal editors rejected it, told the "author" not to submit a paper again, and informed the World Association of Medical Editors. RxComms says this was a different manuscript and was actually written by the person who submitted it, but it had been sent to me in error. AstraZeneca has also denied that the article was ghostwritten. The company says it has strict guidelines, insisting that authors make substantial contributions to these kinds of articles and take responsibility for the contents: "Most pharmaceutical companies, including AstraZeneca, use professional writers to assist in manuscript development, when the named authors lack the time or expertise to produce a well-written publication."

I have found this practice is standard within the industry . . . .

With ghostwritten articles, the author may opt to contribute, but if changes are not advantageous to the sponsoring company, the article may be ditched. We don't know how many of these articles infest medical journals, unbeknown to their editors. Most bona fide journals require authors to disclose conflicts of interest, but editors cannot enforce honesty.

Drug advertising to physicians is aimed at influencing prescribing, but at least is a recognisable form of persuasion. More insidiously, drug companies sponsor many talks at medical meetings or conferences. In the US, it is so common for a lecturer to be in the stable of a drug company that, when invited to speak, I am often asked which firm usually sponsors my talks.

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