Tuesday, January 10, 2006

Giving up the Ghost

We all know about the ethical standards of pharmaceutical companies but now this:

(from In These Times)

You just left the clinic, pills in hand. Odds are your doctor chose them based on slick ads and the word of the perky drug company reps, or relied on research papers presented at professional conferences and in medical journals. Which source would you prefer?

Turns out, there may be little difference: The authors' names at the top of that research article confirming the safety and efficacy of your pills may be no more genuine than a drug rep's smile. Oh, the prestigious docs with the alphabet credentials and the string of affiliations really did sign the article. They just didn't write--or perhaps even read--it. A quiet industry of ghostwriters is churning out custom research for pharmaceutical companies that the London Guardian estimates comprises "almost half of all articles published in journals."

"In order to reduce your workload to a minimum, we have had our ghostwriter produce a first draft based on your published work. I attach it here,'' a drug company rep e-mailed Dr. David Healy, according to the Guardian. When the British researcher investigating the possible dangers of anti-depressants suggested revisions, the drug company replied that he had omitted "commercially important" points. The original paper ended up at the conference--under another doctor's name.These ghostwritten pieces "are no more than infomercials paid for by drug firms," Healy said.

Ghostwriting works like this: Pharma hires a medical education and communications company (MECC) to write the articles, pays academic physicians to sign them, and then places them in medical journals. According to a report by the nonprofit Hastings Center, "Some academics simply sign ghostwritten articles, while others work from a draft supplied by the company. Sticklers for honesty merely take the money and write the articles themselves."

A lawsuit against Zoloft manufacturer Pfizer turned up articles produced by the company's medical communications agency, Current Medical Directions. In place of authors' names, the articles bore the notation "TBD," assumed to mean "to be determined." Hastings reported that between 1998 and 2000, 55 of 96 articles on Zoloft originated at Current Medical Directions, and--surprise, surprise--they painted a "happier profile of Zoloft than did the traditionally authored articles."

Many docs are also happier. "Perhaps I can get you to write all my papers for me!" gushed Richard Atkinson of the University of Wisconsin in a letter to Excerpta Medica, which handled the ghostwriting of his article on Wyeth's Fen-phen weight-control regimen, according to the Dallas Morning News. In 1997, the FDA recommended withdrawing the drug after it was linked to heart and neurological problems, some of which lead to death.

Turns out the "ghost" in ghostwriting may be you.