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

Horse thieving, train robbing and medical ghostwriting

Reid train robber

"An important civic function held in his honor"

I know there are many of my colleagues working in the field of public relations who cringe at the word ‘spin’, as in:

“What kind of positive spin can we put on this horrible mess?”

I am not one of them. Spinning can be an elegant skill (particularly when it means providing clarifying information that might be unknown to your stakeholders) – and more so because it is done rather badly by most.

Consider the spin on this story about a snobbish American politician who was dismayed to learn that his great-great uncle, Remus Reid, was hanged for robbing trains and stealing horses in Montana. In fact, the only known photograph of Remus is this one showing him standing on the gallows in 1889.   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

What if everybody started telling the truth about medical ghostwriting?

ghostwriter cartoon

Once upon a time, the drug giant Wyeth Pharmaceuticals wanted to get some medical journal articles published that would emphasize the positives and de-emphasize the negatives about their hormone replacement drugs, Premarin and Prempro. For the sake of clarity, let’s call this “lying”.

What’s a poor drug giant to do? How about getting well-known medical school professors and researchers to submit HRT-flattering articles to medical journals, pretending that they are the sole authors instead of the  medical ghostwriters you hired who actually wrote them?

And thus a brilliant marketing scam is hatched.   Continue reading