National Post
Tom Spears
Ottawa Citizen; CanWest News Service
Monday, December 01, 2003
OTTAWA - A British psychiatrist was doing research on possible dangers of antidepressant drugs when a representative of a drug manufacturer came to him with an offer of help.
You're a busy guy, the company rep said. Here's some background on our product.
He e-mailed Dr. David Healy a finished 12-page review paper with graphs and footnotes, ready to present at an upcoming conference. And for convenience, Healy's name appeared as the sole author, even though the psychiatrist had never seen a single word of it before.
The drug company wanted its advertising to look like an independent study -- a "massive" scientific fakery that top medical journals condemn because it prevents doctors from getting the straight facts on medicines they prescribe.
Healy looked a gift horse in the mouth.
Fearing the drug company was too easy on its own multimillion-dollar product, he did his own writing.
But the ghostwritten paper appeared verbatim at the conference and in a psychiatric journal anyway -- under another doctor's name.
The drug industry is quietly paying "independent" doctors to sign their names to work they never did -- and keep their mouths shut.
"That of course is unbelievably corrupt and horrible," said Dr. Drummond Rennie, deputy editor of the Journal of the American Medical Association.
"What does it matter what the trials (drug experiments) say if a review is twisted to exclude the unfavourable ones and put a spin on the whole lot? All of which means that your doctor isn't able to know the best treatment, and so you're not going to get it," he said.
"I watch the prescriber's hand pretty damn carefully -- not because I think my doctor's corrupt, but because the information he's got is twisted. And there's massive evidence for that."
At York University in Toronto, Dr. Joel Lexchin said he recognizes the Healy story as a known method for drug makers to ensure they get the right publicity in the scientific press.
"This is ghostwriting. This is something that's not all that uncommon for the drug companies," said Lexchin, a professor at York's School of Health Policy and Management and an emergency physician at a Toronto hospital.
Doctors who receive recruiting pitches from drug companies often forward the letters to Rennie's medical journal.
"I suppose I had about 20 at one time," said Rennie, also a professor of medicine at the University of California at Los Angeles.
" 'Dear so-and-so, we represent such-and-such company. You are an expert in this drug, which is going to be approved by the FDA. We enclose a 40-page review of this drug's effects. Please examine it cursorily -- and that word appears quite often -- and if you approve we will pay you $3,000 or $5,000.' " A doctor who accepts is then listed as sole author.
"And of course, none of this would happen without the willing collusion of greedy doctors, clinical researchers," Rennie said.
"I'm talking about the people you look up to. The top of the profession."
What happens when a doctor is caught?
"They're embarrassed. I know, it's disgraceful. They should be fired," Rennie said.
"They should be disgraced totally, but they aren't. People just think it's a bit naughty."
Today, medical journals demand that all authors sign a document swearing work submitted under their name is really their own.
"This is the kind of thing that largely relies on an honour system," Lexchin said.
But even the honour system can fail. Early this year the New England Journal of Medicine retracted an article on a proposed new treatment for enlarged hearts that it had published in 2002. Some of the paper's "authors" weren't authors at all, and said the real author had forged their signatures to the work.
"There was an egregious disregard of the principles of authorship," the medical journal said in a statement.
It has since tightened its checks on who writes what.
The tactics spill into news releases. One issued Oct. 27 by Cohn and Wolfe, a major Canadian public relations firm, on behalf of Canadian drug maker Merck Frosst/Schering Pharmaceuticals, included positive statements in quotes, followed by a fill-in-the-blank attribution: "... said (name/title of medical expert)."
The release had two pre-written quotes ready for attribution to a doctor.
Back to top of Document