How Big Pharma Bribes Science Journals to Push its Pills
Major pharmaceutical firms employ 250 companies to write rave reviews of new drugs in America's top scientific journals, and pay respected doctors to lend them their bylines.
It's an open secret in the pharmaceutical industry. For years, the nation's most prestigious medical journals have routinely run articles bylined by illustrious doctors praising new prescription drugs. But many of these articles were in fact written by ghostwriters paid by the company promoting the medication. Needless to say, the scam was beneficial for all parties involved. Big Pharma got a scientific stamp of approval, the journals were rewarded with lucrative ad pages, and the doctors were paid a handsome fee for their collusion. But the whole cozy arrangement began to unravel after Congress convened a series of hearings in 2004 to investigate a number of deaths caused by the popular painkiller Vioxx. Halfway through the hearings, to the shock of the committee members, it turned out that a review of Vioxx, published in a leading medical journal under the name of a leading physician, was actually penned by Vioxx itself.
Two papers later published in the Journal of the American Medical Association took the makers of Vioxx (rofecoxib) to task for their role in the manuscript preparation of clinical trial reports. The prestigious journal said it had learned that “many, if not most, rofecoxib clinical trials reports were written by Merck scientists or ghostwritten by Merck-paid contract workers, then disguised with the names of academically affiliated doctors recruited as named authors.” One of the magazines scammed in this manner? The Journal of the American Medical Association itself. After the practice came to light, outraged congressmen demanded an immediate end to the practice. In response, editors of peer-reviewed scientific publications, which are relied on by doctors around the world, implemented new policies requiring "increased vigilance during review," and disclosure of any connections between pharmaceutical companies and physicians..
Now a new investigation by The Guardian shows that even these modest "reforms" are having little effect, leaving doctors and patients alike to question claims about the efficacy and safety of new drugs that are endorsed by such publications. "At least 250 different companies are engaged in the business of planning clinical publications for the pharmaceutical industry," the British paper reports. “We’ve never done 'ghostwriting,' per se" retorts the president of one company named in the The Guardian's investigation. "We may have written a paper, but the people we work with have to have some input and approve it." In fact, authorship of articles is often decided by the drug company only after the "messages" and "narrative" to be spun from the study's data have been determined.
Scientists and academics often turn peevish when confronted about these deceptive practices, arguing that no doctor who wished to retain a credible reputation would sign his or her name to a study that was blatantly biased. But of course, the bias is rarely blatant. Says Dr. Leemon McHenry, a California State University medical ethicist: “It’s a…morass where you can’t trust anything.” Or, as a former medical ghostwriter himself put it: "It’s hard to see when, if ever, we will again see the thick line one likes to imagine there once was between the sale of cornflakes and the analysis of medicine. It has all become rather blurry.”