A day in the life of a medical ghostwriter

With a university degree in biology, young David landed a new job with a medical communications company. His first writing assignment was to produce scientific abstracts for studies of a newly approved antibiotic. Alas, the drug had a major weakness: it didn’t work on pneumococcus, a common bacterium. But this wasn’t something the drug’s manufacturer (David’s client) wanted doctors to know.

So David and his fellow medical writers were ordered to just avoid writing about it.  Continue reading

Is your doctor a “thought leader”?

When a drug company’s sales rep needs to get a doctor to write more prescriptions for his company’s drug, there’s one almost foolproof way to get that task accomplished, according to a revealing National Public Radio report called Drug Company Flattery Wins Docs, Influences Prescriptions.

“To get a doctor to write more prescriptions, the drug rep asks the doctor to become a speaker on the company’s Speakers Bureau.”

For example, drug giant GlaxoSmithKline, like most other drug companies, hires doctors to speak to other doctors as part of their Speakers Bureau marketing efforts. The top GSK drug that their paid Speakers Bureau doctors talk about is called Avodart, a drug prescribed to treat enlarged prostates, and which has been locked in a heated sales battle with its main competition, Merck’s Proscar (now available as a generic).

But over the past five years of these Speakers Bureau presentations, Avodart has seen its sales more than quadruple and its market share double. Convincing a doctor to push your drug to his/her peers during a paid Speakers Bureau presentation really does seem to work.

According to this NPR report (in partnership with the Pulitzer prize-winning investigative journalists from ProPublica), drug companies train their sales reps to approach potential Speakers Bureau doctors in a very specific way. Drug reps use language that deliberately fosters the idea that the Speakers Bureau doctors they hire are educators, and not just educators, but the “smartest of the smart”.

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Stealth marketing: how Big Pharma tries to shape medical news

Although Jeanne Lenzer’s article about stealth marketing in Reporting On Health is actually meant for other journalists, it reminds me that we consumers should all be more savvy when it comes to evaluating medical news. Before my own heart attack, for example, I pretty well swallowed any medical miracle breakthrough news without question.

But because I now take a fistful of powerful cardiac medications everyday, I have become gradually both aware of and alarmed by Big Pharma marketing, and especially about what Dr. Marcia Angell herself (for over 20 years the Editor-in-Chief at the prestigious New England Journal of Medicine) calls “… its pervasive conflicts of interest that corrupt the medical profession.”

In fact, I have absolutely no way of knowing which of my cardiac meds were prescribed for me based on flawed research or tainted medical journal articles that were funded and ghostwritten by the very drug companies who stand to gain by paying for positive outcomes.  And, worse, neither do my doctors. This is allowed to happen in part because of what we now know as stealth marketing“.

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Why you should take Zoloft – for everything!

The smarty-pants over at The Onion have come up with a few new uses for Pfizer’s blockbuster anti-depressant drug Zoloft while taking aim at those Direct-To-Consumer (“ask your doctor”) ads convincing consumers they need it. Even though this concept is a gag, it’s frighteningly close to the reality that Big Pharma is creeping towards.  Continue reading

The medicalization of everyday life

bad science coverDr.  Ben Goldacre, a British doctor writing in his weekly Bad Science column in The Guardian last fall, told this disturbing cautionary tale:

“In 2007, the British Medical Journal published a large, well-conducted, randomised controlled trial, performed at lots of different locations, run by publicly-funded scientists.  It delivered a strikingly positive result.  It showed that one treatment could significantly improve children’s anti-social behaviour. The treatment was entirely safe, and the study was even accompanied by a very compelling cost-effectiveness analysis.

“But did this story get reported as front page news? Was it followed up on the health pages, with an accompanying photo feature, describing one child’s miraculous recovery, and an interview with an attractive happy mother with whom we could all identify?  Continue reading

The business of prostate cancer: putting profit before patients

There’s a simple blood test done routinely to screen men for a condition that is rarely serious.  But if your screening test happens to be positive, the resulting treatment and side effects are likely to be devastating to your day to day quality of life, and may include stress incontinence, overflow incontinence, urge incontinence, or continuous incontinence. And impotence, temporary or permanent.

Should you get this blood test done?

That’s the controversial question behind two large, randomized clinical trials this past year studying the relationship between PSA-based screening and prostate cancer mortality: The European Randomized Study of Screening for Prostate Cancer and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial in the U.S.  According to the European study, which involved over 162,000 men between the ages of 50 and 74 in seven countries, PSA-based screening reduced the already low rate of death from prostate cancer by 20%, but was also associated with a high risk of overdiagnosis and overtreatment.

The American PLCO trial found the rate of death from prostate cancer was very low for both the 38,343 men in the group that received annual PSA-based screening and the 38,350 men in the control group who received “usual care.” The conclusion:

“Screening was associated with no reduction in prostate cancer mortality.”

‘Non-intervention’ is what urologist Dr. Anthony Horan says he was taught when he attended medical school and also during his urology residency at the Columbia Presbyterian Hospital in New York in the mid-1970s. Explains the author of The Big Scare:  The Business of Prostate Cancer:

“We didn’t go looking for the incidental cancers that were of no clinical significance.  And if we found them, we did nothing about them.”  Continue reading