Ghosts in the Medical Profit Machine

Believe in ghosts? The medical profession may seem to be the last place to look for ghosts. But a NEW YORK TIMES article has spotted them in the medical journals that claim to report on objective scientific research that can be trusted for medical practice.

In "Medical Papers by Ghostwriters Pushed Therapy," Natasha Singer reports the sighting of ghostwriters in 26 scientific articles (from 1998 to 2005) in medical journals promoting hormone replacement therapy for women. The giant drug company Wyeth paid a “pharmacological communications firm” (drug advertising agency) to develop articles for respected medical journals. These articles eventually appeared in 18 peer-reviewed medical journals under the names of respected academic researches and professors without mention of their true sponsorship or authorship. The ghost busters were lawyers who took Wyeth to court, The attorneys were sponsored by the NEW YORK TIMES and PLoS Medicine (an open-access journal of the Public Library of Science).

This is not the only evidence of specter’s lurking unseen behind the scientific facade of much of today’s supposedly objective medical research. Here is more information from an article written by Sergio Sismondo (Sismondo, Sergio. "Ghost Management: How Much of the Medical Literature Is Shaped Behind the Scenes by the Pharmaceutical Industry?" PLoS Med 4, no. 9 (2007): e286.)

Sismondo reports that David Healy and Dinah Cattell found that the Pfizer Drug Company was behind 85 of 211 articles on “sertraline” listed in Medline from 1998-2000. That means that Pfizer drugs had “managed” up to 40% of the articles with “sertraline” in the title that were published in the most respected medical journals for that time period. The Pfizer-directed articles were in the most prominent journals, had more prestigious authors, and surely made an impact on the medical view of the drug. Unsurprisingly all the articles were complimentary and the drug’s side effects were minimized. Incidentally, what is “sertraline”? Pfizer named it “Zoloft,” a huge profit-maker.

Researcher Sergio Sismondo says that the drug company involvement in medical research is huge but hard to track down. It funds twice as many clinical trials as non-for-profits. But its role is often hidden. Practices such “honorary authorships” are common. That means, the the drug companies hire agencies or employees to dream up research articles, develop them, and then find respected “name” medical researches and professors to endorse them.

For example, the TIMES gathered evidence that a prominent professor of Obstetrics and Gynecology Dr. Gloria Bachmann signed off on an article written by an article mill (“DesignWrite”). Bachman was caught because she sapproved the outline and first draft of the article by e-mail. By e-mail, she said she made “one correction” to the draft but then said it was “excellent.” According to the TIMES, the article that Bachmann OK'd appeared in the “Journal of Reproductive Medicine" in 2005. The published version was almost exactly like the draft from “DesignWrite.” Backmann denied that she did anything wrong. She said that she lent her expertise to the article. She insisted that her role was to make sure it was accurate. But the article lists her as the author, not the reviewer. Obviously, what she gave the article was her endorsement under cover of her widely respected name.

PubMed lists a total of 56 articles that Bachmann has offered the medical profession. The case of
“her” article “Menopausal vasomotor symptoms: a review of causes, effects and evidence-based treatment options.” makes one wonder how many of other articles amount to no more than product endorsements. It also makes one wonder what her part was in what some have called “the medicalization of menopause."

Sismondo says that to catch the ghosts in the machine of the medical profession, we need to look more broadly at what is going on in this covert marketing of drugs. He calls the sponsorship, design, and development of the articles written on behalf of the drug companies “ghost management.” In sum, drug adverting that appears in medical journals as “research” is just another example of the “managed care system" of today’s medicine.

More and more evidence is coming into view that our present broken health care system is managed by the insurance companies, drug cartels, trial lawyers, and medical institutions. Now these profit-obsessed parties are trying to manage the debate on health care reform. Whether it is in drug research or political debate, they are hiring ghostwriters, honorary authors, and PR agencies to work undercover for them. It’s all rather spooky.