Ghosts in the literature

I am all for an evidence-based approach to assessing the risks and benefits of a health-related intervention, but it seems vitally important that we remain realistic about the possibility that the evidence may not always be as clear as it seems.

A colleague alerted me to a case in the US which has highlighted the practice of publication planning, where pharmaceutical companies may employ the services of a medical education and communication company (MECC) to create and distribute the marketing message around a drug.

Documents revealed through a litigation case against pharmaceutical company Wyeth revealed that this practice extends to the ghostwriting of articles, reviews and commentaries which are placed into medical journals.  Academics are invited to put their name to these pre-written articles and can make changes as long as they do not deviate from the marketing message.

In this specific case more than 14,000 plaintiffs brought claims against Wyeth around the link between the use of menopausal hormone therapy, Prempro, and the development of breast cancer.

The documents that were revealed to be part of the marketing campaign executed by DesignWrite, an MECC, were intended to promote unproven benefits and downplay potential side effects of the drug.  As they were published in respected medical literature they would have played a role in building physician confidence in the drug.

I’m not sure how widespread this practice is, it seems bizarre that it would even be legal.   The point here is that there should be much more transparency about the true authors of any document that gains publication in a medical journal, and with this I wholly agree.

For a much more detailed account of this case please see the article on PLoS Medicine, we have them to thank for bringing this practice to light.