Healthy Skepticism Library item: 1516

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Spears T.
Drug companies get doctors to endorse tainted medical research
Victoria Times 2003 Dec 1

Full text:

OTTAWA — A British psychiatrist was doing research on possible dangers of antidepressant drugs when a representative of one drug manufacturer came to him with an offer of help.

You’re a busy guy, the company rep said. Here’s some background on our product.

He e-mailed Dr. David Healy a finished 12-page review paper with graphs and footnotes, ready to present at an upcoming conference. And for convenience, Healy’s name appeared as the sole author, even though the psychiatrist had never seen a single word of it before.

The drug company wanted its advertising to look like an independent study — a “massive” scientific fakery top medical journals condemn because it prevents doctors from getting the straight facts on medicines they prescribe.

Healy looked a gift horse in the mouth. Fearing the drug company was too easy on its own multi-million-dollar product, he did his own writing.

But the ghostwritten paper appeared verbatim at the conference and in a psychiatric journal anyway — under another doctor’s name.

Like a movie star who gets a chance to review his own films, the drug industry is quietly paying “independent” doctors to sign their names to work they never did — and keep their mouths shut.

Experts say this can undermine the treatment patients receive.

“That, of course, is unbelievably corrupt and horrible,” says Dr. Drummond Rennie, deputy editor of the Journal of the American Medical Association.
“And you don’t have to be any more than a small child to realize that the only reason the person is getting the money is to act as an ad for the drug.

“What does it matter what the trials (drug experiments) say if a review is twisted to exclude the unfavourable ones and put a spin on the whole lot?
All of which means that your doctor isn’t able to know the best treatment, and so you’re not going to get it.

“I watch the prescriber’s hand pretty damn carefully — not because I think my doctor’s corrupt, but because the information he’s got is twisted. And there’s massive evidence for that,” he said.

At York University in Toronto, Dr. Joel Lexchin says he recognizes the Healy story as a known method for drug makers to ensure they get the right kind of publicity in the scientific press.

“This is ghostwriting. This is something that’s not all that uncommon for the drug companies,” says the professor at York’s School of Health Policy and Management, who is also an emergency physician at a Toronto hospital.

Drug firms regularly write a review of their own product and go shopping for a doctor willing to claim this is his or her independent work, for a fee of several thousand dollars, he says.

“Sometimes it’s pretty benign, but a lot of times it’s just a way of making sure that a positive message about your drug gets out,” he says.

Doctors who receive recruiting pitches from drug companies often forward the letters to Rennie’s medical journal.

“I suppose I had about 20 at one time,” said Rennie, who is also a professor of medicine at the University of California at Los Angeles.

“And of course, none of this would happen without the willing collusion of greedy doctors, clinical researchers. I’m talking about the people you look up to. The top of the profession.”

What happens when a doctor is caught claiming to be the author of a paper written by someone else?

“They’re embarrassed. I know, it’s disgraceful. They should be fired,” Rennie said. “They should be disgraced totally, but they aren’t. People just think it’s a bit naughty.”

The British medical journal The Lancet asked in its lead editorial of April 6, 2002: “Just how tainted has medicine become?”

“Heavily, and damagingly so, is the answer,” according to the editorial.

Them’s fighting words, like seeing Sports Illustrated attack the Olympics and the Super Bowl. Yet The Lancet points to increasingly close links between researchers and the companies whose products they study.

Today, medical journals demand all authors sign a document swearing this really is their own work.

“This is the kind of thing that largely relies on an honour system,” Lexchin says.

But even the honour system can fail. Early this year, the New England Journal of Medicine retracted an article on a proposed new treatment for enlarged hearts it had published in 2002. Some of the paper’s “authors” weren’t authors at all, and said the real author had forged their signatures to the work.

“There was an egregious disregard of the principles of authorship,” the medical journal said in a statement.

It has since tightened its checks on who writes what.

The questionable tactics spill over into news releases. Here’s one issued Oct. 27 by Cohn and Wolfe, a major Canadian public relations firm, on behalf of Canadian drug maker Merck Frosst/Schering Pharmaceuticals. The firm forgot to proofread:

“ ‘While most patients will probably be able to achieve target levels for LDL-C with a statin, treatments such as ezetimibe have a role in helping patients at risk, who are not reaching treatment targets with a statin alone, get to goal.’ said (name/title of medical expert).”

In all, the release had two pre-written quotes ready for attribution to a doctor.

Meanwhile, Dr. David Healy has written a book called Let Them Eat Prozac, about ghostwriting and its effects in making Prozac, Paxil and related antidepressants seem safer than he believes they are.