ACROSS the western world, the influence of pharmaceutical companies on the way their products are perceived is palpable. They pay for and design medical education, control direct-to-consumer marketing, fund research, help finance medical journals through advertising, influence how doctors prescribe and fund speakers to help promote their drugs.
Most people won’t be surprised to learn that they also seek to shape what is published in journals through ghost-written essays signed by prestigious doctors, or attempt to influence prescribers’ opinions through widely distributed “throwaways”, a euphemism for journal articles that support their products.
But even the most hardened cynics were left open-mouthed last month by the news that the Australian affiliate of the global drug giant Merck had signed up with publisher Excerpta Medica, a division of Elsevier (a sister company ofNew Scientist) to produce a publication with the look and feel of a peer-reviewed journal, yet which contained only reprints of articles, most of them sympathetic towards Merck products.
The Australasian Journal of Bone and Joint Medicine was sent to up to 20,000 doctors between 2003 and 2005. The publication had no website and, unlike normal journals, was not open for submissions. Neither was there any disclosure that it was funded and controlled by Merck. Elsevier has since revealed that it put out five other industry-sponsored titles between 2000 and 2005 under its Excerpta Medica imprint.
Several journal editors have testified that only a keen and experienced eye would have recognised that the journal was a marketing aid. Yet its production is not that far removed from a practice that has been going on for some time without much resistance: the corporate funding of special supplementary issues of journals. These are paid for and often overseen by pharmaceutical companies, which are careful to select articles that promote their products. Because of their stylistic similarity to the parent journal, few readers understand that these supplements do not meet comparable editorial standards.
Only a keen, experienced eye would have recognised that the journal was a marketing aid
This blurring of the boundaries between independently refereed publications and advertorials is unacceptable. Promotional material should be clearly marked and easily identifiable. The production of drugs and the production of reliable knowledge about their safety and use must be kept separate.
Sheldon Krimsky is adjunct professor in the Department of Public Health and Family Medicine at Tufts University in Medford, Massachusetts