The haunting of medical journals: how ghostwriting sold hormone replacement therapy

I’ve been writing about (and against) medical ghostwriting since I first learned about this Big Pharma marketing practice. In fact, my gobsmacked reaction to this very subject is largely why the Ethical Nag site was launched in the first place. I had just learned about lawsuits* filed in the U.S. by thousands of women diagnosed with breast cancer – a diagnosis suspiciously linked to their hormone replacement therapy (HRT). And recently the journal Public Library of Science Medicine (who with the New York Times originally broke the story) published an unprecedented analysis of the issue that caused the link.

The poster child of medical ghostwriting is Wyeth Pharmaceuticals Inc. (now owned by Pfizer, the world’s biggest drug company) who were then the makers of the best-selling HRT drugs on earth, Premarin and Prempro.

Wyeth’s ghostwritten medical journal articles attempted to:

  • mitigate the perceived risks of breast cancer associated with HRT
  • defend the unsupported cardiovascular “benefits” of HRT
  • promote off-label, unproven uses of HRT such as the prevention of dementia, Parkinson’s disease, vision problems, and wrinkles.

But first, what exactly is medical ghostwriting? And why is it so bad?   Continue reading

True or False? Most smokers need help to quit

“I only eat about 30 a day now”

I am every smoker’s worst nightmare. As an ex-smoker myself  – it was the 60s during my art college days, what can I say? –  I now have little tolerance for smokers who whine about how tough it is to quit. Back when I finally decided to kick the stinky habit, before marrying David (my anti-smoking fiancé), we were still 20 years away from modern quit-smoking help. There were no nicotine patches or pills or gum or any program to help us. It was just white-knuckling cold turkey and hard candy all the way – what scientists call unaided smoking cessation.

But Australiaresearch published this spring in the Public Library of Science Medicine now suggests that unaided cessation methods (cold turkey or gradually reducing before quitting) is actually the most successful way to quit after all, despite Big Pharma’s expensive campaigns to convince us why we need to buy their products if we really want to quit.

In fact, as with problem drinking, gambling, and narcotics use, population studies show consistently that up to three-quarters of smokers who permanently stop smoking do so without any form of assistance Continue reading

There’s a pill for that!

No matter what ails you, there’s a pill for it. And if nothing ails you, just wait. Pharmaceutical companies are working on drugs right now that just need a disease to treat. So let’s invent one!  It’s what Big Pharma watchers call disease-mongering. For example, we used to call it laziness, but now we know that it’s really a medical condition called Motivational Deficiency Disorder. And don’t even get me started on Hypoactive Sexual Desire Disorder!

Need to take a pill for something, anything? We’ve got drugs for everything.

The term ‘disease-mongering’ was first coined by author Lynn Payer in the 1992 book Disease Mongers: How Doctors, Drug Companies and Insurers Are Making You Feel Sick. Ray Moynihan, Iona Heath and David Henry then wrote this in April of that same year in the British Medical Journal:

“Pharmaceutical companies sponsor diseases and promote them to both prescribers and consumers.

“There’s a lot of money to be made from telling healthy people they’re sick. Some forms of medicalising ordinary life may now be better described as disease mongering: widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments.

“The social construction of illness is being replaced by the corporate construction of disease.” Continue reading

Medical ghostwriting: if you’re not alarmed, maybe you’re just not paying attention

ghostwriting questions money I had to go have a little lie-down after I read the The New York Times story this week about the scandalous practice of  medical ghostwriting. Here’s how Danish researcher Dr. Peter Gøtzsche describes medical ghostwriting:  “Ghostwriting occurs when someone makes substantial contributions to a manuscript without attribution or  disclosure. It is considered bad publication practice in the  medical sciences, andsome argue it is scientific misconduct. At its extreme, medical ghostwriting involves pharmaceutical companies hiring professional writers to produce papers promoting their products–  but hiding those contributions and instead naming academic physicians or scientists as the authors.

Here’s an extreme example of extreme medical ghostwriting. The New York Times and the journal Public Library of Science Medicine have outlined recent court documents revealing that ghostwriters paid by drug giant Wyeth Pharmaceuticals played a major role in producing 26 scientific papers published in medical journals that backed the use of hormone replacement therapy in women. That supposed medical consensus benefited Wyeth directly, as sales of its HRT drugs Premarin and Prempro soared to nearly $2 billion by 2001.   Continue reading