Abstract
Ghostwriting for medical journals has become a major, but largely invisible, factor contributing to the problem of credibility in academic medicine. In this paper I argue that the pharmaceutical marketing objectives and use of medical communication firms in the production of ghostwritten articles constitute a new form of sophistry. After identifying three distinct types of medical ghostwriting, I survey the known cases of ghostwriting in the literature and explain the harm done to academic medicine and to patients. Finally, I outline steps to address the problem and restore the integrity of the medical literature.
Highlights
Pharmaceutical companies commonly employ ghostwriters, or uncredited authors, to write or draft manuscripts that subsequently appear in peer-reviewed medical journals under the name of one or more academic researchers
This “publications strategy” is an integral component of drug development and marketing, but problems arise when manuscripts are developed with a focus on marketing goals and with little or no consultation from the eventual ‘authors.’ As a consequence, it is frequently unclear which, if any, published studies represent independent evaluation of a company’s products
Pharmaceutical marketing documents reveal that medical journal articles, letters to the editor and abstracts for professional conferences are designed to give the sales force “tools to drive prescriptions” (Moffatt and Elliott, 2007)
Summary
Pharmaceutical companies commonly employ ghostwriters, or uncredited authors, to write or draft manuscripts that subsequently appear in peer-reviewed medical journals under the name of one or more academic researchers. Legal proceedings against drug manufacturers for product liability and fraud reveal behind the scenes organization of publication strategy, contracts with medical communications companies and the participation of key opinion leaders Some of these cases illustrate how industry control of manuscripts can facilitate manipulation of data to favor the study medication. GSK’s ghostwriting program, CASPPER, was revealed in court documents, the president of one medical communication company, Rockpointe, defended ghostwriting as “common practice” and claimed: “ghostwriting is legal, but it is necessary and essential in producing timely information to the public about drugs and devices Without such a practice, patients, doctors, and science itself would be at a standstill because the timing of such articles would be severely altered without ghostwriting” (Sullivan, 2009). In order for the journals to be fully transparent, they should disclose their own revenue related to sale of reprints, pharmaceutical advertising and journal supplements
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