Journal rejects article after objections from marketing department

[Guest guest]

http://bmj.bmjjournals.com/cgi/content/full/328/7434/244-b?ecoll

 

BMJ 2004;328:244 (31 January), doi:10.1136/bmj.328.7434.244-b

 

Journal rejects article after objections from marketing department Owen Dyer

London

 

A leading nephrology journal has rejected a guest editorial questioning the

efficacy of epoetin in end stage renal disease, despite favourable peer reviews,

apparently because it feared losing advertising. In a letter to the author of

the proposed editorial, the executive editor of the California based journal

Transplantation and Dialysis said he had been " overruled by our marketing

department. "

The editorial was written by Dennis Cotter, president of the non-profit making

Medical Technology and Practice Patterns Institute. In it, he argued that the US

National Kidney Foundation's existing guidelines on end stage renal disease rely

on flawed logic in claiming a survival benefit associated with higher packed

cell volume (haematocrit) achieved through epoetin treatment.

Joseph Herman, editor of the journal, told Mr Cotter in a letter that: " I have

now heard back from a third reviewer of your EPO editorial, who also recommended

that it be published.... Unfortunately, I have been overruled by our marketing

department with regard to publishing your editorial.

" As you accurately surmised, the publication of your editorial would, in fact,

not be accepted in some quarters... and apparently went beyond what our

marketing department was willing to accommodate. Please know that I gave it my

best shot, as I firmly believe that opposing points of view should be provided a

forum, especially in a medical environment, and especially after those points of

view survive the peer review process. I truly am sorry. "

Mr Cotter's editorial said the evidence cited in support of a survival benefit

" is subject to a fundamental error that confuses the relationship between

treatment response and outcomes with a causal effect of the treatment. "

His editorial also pointed out that, despite a steady increase in the target

packed cell volumes and epoetin doses over the past decade in the United States,

mortality from end stage renal disease has remained steady. He wrote: " A 2002

Cochrane Review of randomised trials of epoetin concurred with the European

guidelines concluding that the benefits associated with higher hematocrit levels

are outweighed by the risk of increased hypertension and mortality. "

The editorial was submitted in response to a call from the Centers for Medicare

and Medicaid Services for public help in review of its policy on epoetin use

among patients with end stage renal disease. It was concerned that " Medicare

spending on EPO may be higher than necessary without resulting in optimal

patient benefit. " Medicare spent over $7.6bn (£4.2bn; 6.1bn) on epoetin between

1991 and 2002.

Arthur Caplan, chair of the Department of Medical Ethics at the University of

Pennsylvania, said: " It is completely unethical for a marketing or business

related part of a journal to have any say over the content of a journal. "

Mr Hermann said: " I absolutely refuse to comment. This whole issue is being

blown out of proportion. "

 

 

 

Dr Cotter's editorial can be accessed at www.mtppi.org

 

 

 

 

 

 

 

SiteBuilder - Free web site building tool. Try it!