“It’s prostitution!” claims University of Toronto professor of law and medicine, Trudo Lemmens, describing how medical school academics engaging in ghostwriting “undermine the integrity of the whole system”.

But since few academics will ever confess that they weren’t actually the real authors of all the medical journal articles they have taken credit for, the full extent of drug company-funded medical ghostwriting fraud may never be known. With the recent public release of 1,500 court documents implicating drug giant Wyeth Pharmaceuticals and its partners in slime, maybe now the medical profession will finally develop a collective backbone.

This isn’t just about one slimy drug company getting caught red-handed and facing 8,400 lawsuits* (since independent, federally-funded research indicated an increased risk of heart disease and breast cancer for patients who were prescribed hormone replacement therapy drugs like Wyeth’s Premarin and Prempro).

It’s not just about 26 medical school professors now embarrassed in the media for claiming to be the authors of pro-HRT medical journal articles that they didn’t write.

It’s not just about medical journal editors who are publishing what they must know are fraudulent scientific papers written by medical ghostwriters bought and paid for by drug companies.

This is all about you.

This is about your health and every kind of drug or treatment or medical device or procedure your body will ever be subjected to, now and for the rest of your life.

It’s about who you and your family can trust in health care.

Medical ghostwriting is pervasive. Trudo Lemmens cites a 2003 study in The British Journal of Psychiatry revealing that over half of all published medical journal articles about the Pfizer anti-depressant drug Zoloft over a three-year period were actually written by Pfizer’s hired New York ghostwriting firm – and not the academics who claimed to be the articles’ authors. The rest were written by independent medical researchers who actually did the work.

Guess whose articles were more positive about Zoloft?

My former corporate PR self might have cynically said that it’s simply savvy business practice for all drug companies to hire medical ghostwriters. Here’s how it works:

• You can get dozens of favourable medical journal articles published about your drugs that claim, fraudulently, to be authored by noted researchers instead of your own paid ghostwriters.
• Other doctors out there then read these published journal articles, and are duly convinced to start prescribing more of your drugs to their patients.
• Your drug company makes lots of money.
• You get a big bonus at the end of the year.
• The academics get to painlessly claim authorship of yet another journal publication for their CVs.
• Everybody wins. Except for the patients.

Those medical ghostwriters are now coming forward to claim defensively: “Hey! What’s the big deal? We’re like editors – just helping these poor doctors to improve their writing skills!”

But Stuart Laidlaw in his Toronto Star medical ethics column replied this way in his essay called “Ghostwriting: What’s The Harm?”:

“No reporter would discount the role of a good editor. Any story that appears in a newspaper has been edited two or three or more times before it appears in print. This is not ghostwriting. Ghostwriting happens when an anonymous writer prepares an article that is edited by a respected researcher in the field. The editor’s name then appears on the paper as author. No newspaper I know assigns bylines that way.”

The biggest danger of ghostwriting, said James Szaller, a Cleveland lawyer leading a large class-action suit against Wyeth, is that doctors rely on such journal articles when caring for their patients.  He says:

“It puts patients at risk, and doctors are relying on marketing materials and not true clinical studies or unbiased reviews of the medical literature. It’s insane.”

In the interests of not letting the slimy go free, I urge you to join the ranks of those of us who are spitting mad about the common drug and device industry practice of medical ghostwriting.

Let’s keep this issue alive long enough to get it kicked to the curb forever.

* NEWS UPDATE:   November 5, 2009 - A Philadelphia jury has ordered Wyeth to pay a $75 million bad-conduct award (about 20 times larger than the $3.7 million in actual damages the panel awarded to Connie Barton, an Illinois woman who developed cancer after taking Wyeth’s Prempro menopause drug).  Barton, a retired records clerk took Prempro for five years before developing breast cancer in 2002.  Jurors in Philadelphia concluded Prempro helped cause the illness, and the manufacturer failed to warn Barton and her doctors adequately about the drug’s risks. Wyeth has now lost five of eight trials, including the last three in a row, since HRT cases began reaching juries in 2006. New York-based Pfizer, the world’s biggest drug company, completed its $68 billion purchase of Wyeth on October 15th.  Watch this five-minute video about Connie Barton’s successful lawsuit against Wyeth.

*NEWS UPDATE:  December 15, 2011 (via Bloomberg Business Week):  Pfizer, the world’s largest drugmaker, and its Wyeth and Pharmacia & Upjohn units, have now settled almost half of the lawsuits over its menopause drugs and increased the funds set aside to resolve the cases, the company said in a regulatory filing. The suits claimed the companies’ hormone-replacement medicines, including Prempro and Premarin, caused breast cancer, according to the Securities and Exchange Commission filing. Pfizer said it added $68 million to the $772 million it already reserved for the cases.

More than 6 million women took Prempro and related menopause drugs to treat symptoms including hot flashes and mood swings before a 2002 study highlighted their links to cancer. Wyeth’s sales of the medicines, which are still on the market, exceeded $2 billion before the release of the Women’s Health Initiative study sponsored by the National Institutes of Health.

At the height of the litigation, Pfizer faced more than 10,000 claims that its menopause drugs caused breast cancer.

 Earlier this month, a Philadelphia jury ordered the Pfizer units to pay $72.6 million in compensatory damages to three women who blamed the drugs for their breast cancers. Pfizer agreed to settle the case before jurors were asked to decide whether the company should face punitive damages. Terms of the settlements weren’t released.

Visit the Public Library of Science Medicine journal to learn more about medical ghostwriting and their recommendations for making medical literature transparent and credible.

See also:

• Medical Ghostwriting: If You’re Not Alarmed, You’re Just Not Paying Attention
• Partners in Slime: Why You Should Be Alarmed About Medical Ghostwriting
• What if Everybody Just Told The Truth About Medical Ghostwriting?
• How Are Hockey-Playing Goons the Same as ‘Puzzled” Medical Journal Editors?
• Medical Ghostwriting and ‘Guest Authorship’: Twins Separated at Birth?
• How Are Hockey-Playing Goons the Same as ‘Puzzled’ Medical Journal Editors?
• Why Doctors Who Pretend to Write Medical Journal Articles Should Be Punished