How Drug Companies Covertly Influence the Content of Medical Literature

April 16, 2008 by: David Gutierrez
Pharmaceutical companies regularly carry out every aspect of a study on their products, then solicit academics to put their names on the final papers in order to disguise their involvement, according to an essay published in the journal PLoS Medicine. Author Sergio Sismondo calls this practice "ghost management," to distinguish it from mere ghost writing.

"In extreme cases, drug companies pay for trials by contract research organizations (CROs), analyze the data in-house, have professionals write manuscripts, ask academics to serve as authors of those manuscripts, and pay communication companies to shepherd them through publication in the best journals," Sismondo writes. "The resulting articles affect the conclusions found in the medical literature, and are used in promoting drugs to doctors."

Sismondo points to a study conducted by David Healy and Dinah Cattell, who analyzed Pfizer's involvement in managing studies on its product Sertraline. The researchers uncovered that through a CRO, Pfizer was keeping careful track of these studies from planning to publication. The articles managed by Pfizer comprised between 18 and 40 percent of all articles published on the drug between 1998 and 2000.

These articles were universally positive about the drug and under-reported its side effects. They were also published in more prestigious journals and were cited nearly three times as frequently as more critical articles not managed by the company.

Ghost management has become such a huge industry that a professional association has even been established for it -- the International Publication Planning Association.

Sismondo notes that while Healy and Cattell looked at only one drug, the evidence suggests that ghost management is widespread. When it was revealed that a journal article on Merck's drug Vioxx had failed to mention the deaths of certain participants, for example, lead author Jeffrey Lisse pleaded innoncence: "Merck designed the trial, paid for the trial, ran the trial," Lisse said. "Merck came to me after the study was completed and said, 'We want your help to work on the paper.' The initial paper was written at Merck, and then it was sent to me for editing."