(Press-News.org) The first academic analysis of the 1500 documents unsealed in recent litigation against the pharmaceutical giant Wyeth (now part of Pfizer) reveals unprecedented insights into how pharmaceutical companies use ghostwriters to insert marketing messages into articles published in medical journals. Dr. Adriane Fugh-Berman, associate professor in the Department of Physiology at Georgetown University Medical Center in Washington DC, analyzed dozens of ghostwritten reviews and commentaries published in medical journals and journal supplements that were used to promote unproven benefits and downplay harms of Prempro—a brand of menopausal hormone therapy (HT)—and to cast competing therapies in a negative light. These articles were widely circulated to drug reps and doctors to disseminate the company's marketing messages. The analysis appears in this week's PLoS Medicine.
Wyeth used a medical education & communication company, DesignWrite, to produce ghostwritten articles in order to mitigate the perceived risks of breast cancer associated with HT, to defend the unsupported cardiovascular ''benefits'' of HT, and to promote off-label, unproven uses of HT such as the prevention of dementia, Parkinson's disease, vision problems, and wrinkles, writes Fugh-Berman.
The analysis revealed that DesignWrite was paid US$25,000 to ghostwrite articles reporting clinical trials, including four manuscripts on the HOPE trials of low-dose Prempro. DesignWrite was also assigned to write 20 review articles about the drug, for which they were paid US$20,000 each.
The analysis concludes that "Given the growing evidence that ghostwriting has been used to promote HT and other highly promoted drugs, the medical profession must take steps to ensure that prescribers renounce participation in ghostwriting, and to ensure that unscrupulous relationships between industry and academia are avoided rather than courted."
In July 2009, PLoS Medicine, represented by the public interest law firm Public Justice, and The New York Times acted as intervenors in litigation against menopausal hormone manufacturers by 14,000 plaintiffs whose claims related to the development of breast cancer while taking the hormone therapy Prempro (conjugated equine estrogens). This resulted in a US federal court decision to release approximately 1500 documents to the public. The Wyeth Ghostwriting Archive is available at http://www.plosmedicine.org/static/ghostwriting.action or through the UCSF Drug Information Document Archive at http://dida.library.ucsf.edu/documents.jsp
### Funding: The author received no specific funding for this article.
Competing Interests: Dr. Fugh-Berman was a paid expert witness on behalf of plaintiffs in the litigation referred to in this paper. She was not paid for any part of researching or writing this paper. Dr. Fugh-Berman directs PharmedOut, a Georgetown University-based project founded with public money from the Attorney General Consumer and Prescriber Grant program and currently supported by individual donations.
Citation: Fugh-Berman AJ (2010) The Haunting of Medical Journals: How Ghostwriting Sold ''HRT''. PLoS Med 7(9): e1000335. doi:10.1371/journal.pmed.1000335
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000335
PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-07-09-fugh-berman.pdf.
Funding: The author received no specific funding for this article.
Competing Interests: Dr. Fugh-Berman was a paid expert witness on behalf of plaintiffs in the litigation referred to in this paper. She was not paid for any part of researching or writing this paper. Dr. Fugh-Berman directs PharmedOut, a Georgetown University-based project founded with public money from the Attorney General Consumer and Prescriber Grant program and currently supported by individual donations.
Citation: Fugh-Berman AJ (2010) The Haunting of Medical Journals: How Ghostwriting Sold ''HRT''. PLoS Med 7(9): e1000335. doi:10.1371/journal.pmed.1000335
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000335
PRESS-ONLY PREVIEW OF THE ARTICLE:
CONTACT:
Adriane Fugh-Berman
Georgetown University Medical Center
Physiology and Biophysics
Box 571460
Washington, DC 20057-1460
United States of America
202-687-7845
202-687-7407 (fax)
ajf29@georgetown.edu
For more posts and information on ghostwriting in medical literature, see the Speaking of Medicine blog: http://speakingofmedicine.plos.org/category/ghostwriting/
Other information about PLoS Medicine relevant to journalists, bloggers and press officers, including an outline of our approach to the media, our embargo policy, and how you can re-use of PLoS Medicine material, see the Speaking of Medicine blog: http://speakingofmedicine.plos.org/media/
END
Evaluating the quality of care delivered by individual physicians without accounting for such factors as their patients' socioeconomic status or insurance coverage risks undervaluing the work of those caring for a higher proportion of vulnerable patients. In the Sept. 8 Journal of the American Medical Association a team of Massachusetts General Hospital (MGH) researchers describe finding that primary care physicians' rankings on common quality measures appear to be associated with the characteristics of the patients they care for. Adjusting physician rankings based on ...
An international consortium of researchers has completed the majority of the genome sequence of the domesticated turkey, publishing it in the online open-access journal PLoS Biology next week. In 2008, the research consortium set out to map the genetic blueprint for the domesticated turkey, the fourth-most popular source of meat in the United States. The complete genome sequence, rapidly acquired using 'next-generation' sequencing technology, promises new data for avian researchers and, ultimately, a better quality product for turkey producers and consumers.
"To date, ...
Obese women have a well-known risk for infertility, but a new Johns Hopkins Children's Center study has unraveled what investigators there believe is the mechanism that accounts for the risk.
The research, conducted in mice and published online on Sept. 8 in the journal Cell Metabolism, shows that the pituitary gland actively responds to chronically high insulin levels, triggering a cascade of hormonal changes that disrupt ovarian function and impair fertility.
The findings challenge the widely held belief that infertility is a result of insulin resistance — a body's ...
An analysis of data from influenza cases in Wisconsin indicates individuals with 2009 H1N1 infections were younger than those with H3N2 (2007-2008), and that the risk of most serious complications was not higher in adults or children with 2009 H1N1 compared with recent seasonal strains, according to a study in the September 8 issue of JAMA.
"The pandemic 2009 influenza A(H1N1) virus caused widespread transmission in the United States and other countries. The Centers for Disease Control and Prevention (CDC) estimates that 43 million to 89 million infections occurred in ...
Patients panels (used to rate the quality of care of physicians) with greater proportions of underinsured, minority and non-English speaking patients were associated with lower physician quality rankings, according to a study in the September 8 issue of JAMA.
Physicians have increasingly become the focus of quality performance measurement. Many health care systems now use physician clinical performance assessment as part of their re-credentialing process, and public reporting programs have become widely adopted approaches to influence clinician performance. "These programs ...
Infants who received heptavalent pneumococcal conjugate vaccination (PCV-7) at 2, 4, and 11 months were more likely than unvaccinated controls to have nasopharyngeal (in the nasal passages and upper part of the throat behind the nose) acquisition of pneumococcal serotype 19A, a leading cause of respiratory pneumococcal disease, according to a study in the September 8 issue of JAMA.
"A rapid increase in the presence of pneumococcal serotype 19A strains that are often multiresistant to antibiotics has been observed over the last decade. In the United States, serotype 19A ...
Fetal exposure to radiation and the risk of childhood cancer: what is the likelihood of a risk?
A new study published in this week's PLoS Medicine aims to evaluate the possibility that exposure of a fetus to computed tomography or radionuclide imaging performed during pregnancy might increase subsequent risk of childhood cancer. The researchers concluded that despite the very large size of their study they were unable to exclude the possibility of a very slight risk, and advise that beta hCG testing (blood pregnancy test) should continue to be done in all potentially ...
There is an association between taking statins (lipid lowering drugs), and reduced risk of developing the chronic inflammatory disease, rheumatoid arthritis. These are the findings of a study by Gabriel Chodick and colleagues, published in this week's PLoS Medicine.
The researchers conducted a retrospective cohort study among the 1.8-million members of Maccabi Healthcare Services (a health maintenance organization [HMO]) in Israel to identify adults who regularly took statins and did not have rheumatoid arthritis. Using Maccabi's large automated datasets, the researchers ...
Interactive computer packages are effective in improving knowledge about sexual health, according to a new study by Cochrane researchers. Computer-based approaches could help to tackle problems such as sexually transmitted infections and unwanted pregnancy.
Patients may be unlikely to discuss sexual health concerns with health professionals because of the sensitivity of the issues, or simply because healthcare providers have limited time. Computer-based interventions are a promising alternative and have already proved successful in the promotion of HIV-related sexual ...
Acamprosate reduces the number of patients being treated for alcoholism who return to drinking, according to a new Cochrane Systematic Review. The drug showed moderate benefits in trials when used in addition to non-drug treatments.
Drinking too much alcohol increases the risk of ill health. According to the World Health Organization, alcohol misuse is at the root of around a quarter of all cases of oesophageal cancer, liver disease and epilepsy, as well as road accidents and homicides. Acamprosate and naltrexone are drugs used alongside psychosocial methods to help ...