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" Misty L. Trepke "

Sun, 26 Oct 2003 15:54:16 -0000

[s-A] Medical Ghostwriting

 

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Misty L. Trepke

http://www..com

 

Medical Ghostwriting

 

 

*********** BEGIN FORWARDED MESSAGE ***********

 

http://www.cbc.ca/consumers/markethealth/ghostwriting/

 

Air Mar 25, 2003

Reporter: Erica Johnson

Producer: Michael Gruzuk

Researcher: Colman Jones

 

Medical ghostwriting. You may not have heard of it, but you'll

probably want to know about it. It's a world that could make your

doctor prescribe the wrong drug.

 

For trusted guidance articles rigorously reviewed in medical

journals are the gold standard when it comes to scrutinized,

scientific reports. They're what our doctors rely on to make

decisions affecting our health. But more and more we cant be sure

whos serving up that medical advice.

 

Medical ghostwriting can be as scary as it is spooky. People with

scientific backgrounds often, with PhDs are paid to stay in the

shadows and crank out favorable reports for drug companies. Then,

drug companies get doctors to put their names on the studies for

money, prestige, or perks.

 

Marketplace tracked down ghostwriters in Vancouver, Montreal and

Ottawa one agreed to talk with us, but only if we protected their

identity. Their job could vanish if their identity is revealed.

We'll call our busy ghostwriter, Blair Snitch.

 

Blair Snitch: Im given an outline about what to talk about, what

studies to site. They want us to be talking about the stuff that

makes the drug look good.

 

Erica Johnson : They don't give you the negative studies?

 

Blair Snitch: There's no discussion of certain adverse events.

That's just not brought up.

 

Blair Snitch is paid to write up positive reports. So bad side

effects that could affect patient safety, are sometimes completely

ignored.

 

Snitch makes over $100,000 a year as a medical ghostwriter. An

article that makes its way into a prestigious medical journal like

the Lancet, British Medical Journal, New England Journal of Medicine

will earn up to $20,000.

 

Snitchs work is brisk and busy, but not problem free.

 

Erica Johnson: How much pressure is there from the drug company to

write something favorable?

 

Blair Snitch: You're being told what to do. And if you don't do it,

you've lost the job.

 

'A matter of efficiency'

 

Snitch works for what's called a medical writing company. There's a

whole industry churning out drug company bumph. Its partly a matter

of efficiency, says Snitch.

 

Doctors don't have time to write those articles. The people who have

their names on those articles are very busy professionals.

 

Busy and usually high-profile. The higher the profile, the greater

the credibility for the article.

 

What appear to be scientific articles are really infomercials of some

sort, says Dr. David Healy of the University of Wales.

 

Healy's no stranger to controversy: his job at the University of

Toronto was suspended after he criticized the pharmaceutical

industry.

 

I said 'yes' to the meeting. To my big surprise I had an e-mail

shortly afterwards. 'In order to reduce your workload, we have had

our ghostwriters produce a first draft based on your published work.

I attach it here.' "

 

Healy wasn't comfortable with the glowing review of the drug, so he

crafted his own article. The drug company wrote back and said he'd

missed something key. In the end, the drug company put someone

else's name on the article.

 

Healy is spooked by the deception. He says it goes beyond being

misleading it can be dangerous. He's seen a lot of articles on

drugs like anti-depressants that don't mention serious problems.

 

People and children, for instance, that have been put on these drugs,

actually committing suicide. Or becoming suicidal. But the finished

articles actually don't reflect this at all.

 

Blair Snitch says the public should be concerned.

 

" Are they being prescribed a drug because it's the

best drug or because its the drug most favorably positioned? "

 

Erica Johnson: Do you have any concerns about what you're doing?

 

Blair Snitch: I don't feel ownership of the product.

 

Erica Johnson: But you are taking the research and delivering to the

drug company something that's favorable.

 

Blair Snitch: I expect that all the drug companies are doing it with

all the drugs. So I figure in the end, it'll be balancing itself out.

 

Healys not so sure. He's seen internal drug company

documents. They had lists of scientific papers written up, ready to

go. All that was missing, was the name of a high profile doctor to

be listed as author.

 

Healy estimates as much as 50 per cent of the literature on drugs is

ghostwritten.

 

Ghostwriters we talked to said they do a good job of taking

complicated science and turning it into something understandable.

 

We wanted to ask a doctor why they'd agree to sticking their name on

a paper. But its tricky getting people to fess up. Some doctors

didn't call back. One we reached said he couldn't remember who wrote

the paper his name was on. Then said the drug company might have

written the first draft. But by the end of our conversation, he'd

remembered he'd written every word.

 

The worlds leading medical journals say they're trying to ferret

out who lurks behind the pen. When a study is submitted to top

journals like the Canadian Medical Association Journal, The Lancet,

New England Journal of Medicine, everyone whose had anything to do

with the article is listed like a film credit.

 

John Hoey, the editor of the CMAJ, admits it's a tough rule to

enforce.

 

" We have no way of checking. We barely have the resources to do what

were doing, let alone whether so-and-so is telling us honestly what

they did. "

 

Hoey says drug companies don't just want positive articles, but

positive research results.

 

But some critics say all this industry influence is a problem because

ghostwriters rely on research material that's given to them by drug

companies so it may be biased to begin with. That means even

ghostwriters might not know about negative side effects and safety

problems.

 

'Clearly unethical'

 

I think it is clearly unethical, " said Dr. Mohit Bhindari, an

orthopaedic surgeon at McMaster University. He's just penned a

report on drug company studies one that he wrote himself.

 

If you have funding from an industry sponsor, you are four times more

likely to include a positive, pro-industry result which favors that

particular industries product.

 

Bhindari says researchers have told him there's pressure to come up

with " good results. "

 

Dr. David Healy says that's dangerous and has to change.

 

The only way to know whether the articles really are honest is for

people, if need be, to be able to get access to the raw data.

 

Blair Snitch is in a rush to go. There's another big drug company

contract to work on, with no regrets.

 

Blair Snitch: As long as I do my job well, its not up to me to

decide how the drug is positioned. Im just following the information

Im being given.

 

Erica Johnson: Even though you know that information is often biased?

 

Blair Snitch: The way I look at it, if doctors that have their name

on it, that's their responsibility, not mine.

 

So for now, keep in mind that medical information you read may be

other-worldly. Since people paid big bucks to spin research show no

sign of giving up the ghost.

 

More information about medical ghostwriting can be found at:

http://www.cbc.ca/consumers/markethealth/ghostwriting/

 

 

 

 

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