Editor claims drug companies have a parasitic relationship with journals

[Guest guest]

BMJ 2005;330:9 (1 January), doi:10.1136/bmj.330.7481.9

 

Editor claims drug companies have a " parasitic " relationship with journals

 

London Lynn Eaton

 

The relationship between medical journals and the drug industry is

" somewhere between symbiotic and parasitic, " according to the editor

of the Lancet, Richard Horton. But at the moment it has swung too much

towards the parasitic, he told the House Commons select committee on

health last month in his oral evidence on the role of the industry.

 

He outlined some of the financial incentives that could, potentially,

influence a commercially run medical journal to publish a paper. Many

of the formal research papers in the Lancet are reprinted and bought

in bulk by drug companies, which use them for marketing purposes, he

explained. The drug companies regularly try to exert pressure on the

journal to run a paper by arguing that, if the journal does so, they

will buy reprints, which will earn the journal more money, he said.

 

He explained that the Lancet regularly gets calls from authors trying

to see whether the journal might be interested in a paper. " The

conversation might go: `It's likely the company will want to buy

several hundred reprints of this paper,' " he said.

 

As another example of the parasitic nature of the relationship Dr

Horton cited the example of a recently submitted paper on

cyclo-oxygenase-2 inhibitors. When the journal raised questions with

the authors over the paper, the drug company sponsoring the research

called Dr Horton, asking him to " stop being so critical. "

 

He reported to the committee that the company told him, " If you carry

on like this we are going to pull the paper, and that means no income

for the journal. "

 

" That is just one example, and it is not that uncommon, " he told the

committee.

 

He outlined some of the measures that had been introduced across

medical journals, including the BMJ, to try to reduce research fraud

and to eliminate " ghost writing " of leading editorials. But he said

this was based on people being honest.

 

" However, people do lie, " he said.

 

One author had claimed that a review was written by him but had made

the mistake of leaving on Microsoft Word's " track changes " facility in

the document he sent, revealing that in fact everything had been ghost

written with the help of the manufacturer of the drug. It carried the

telltale note " marketing approval required please. " " The paper was

rejected, " said Mr Horton.

 

He also hit out at the way drugs were regulated in Britain and decried

as " nonsense " the yellow card system for reporting adverse reactions.

 

" That is the worst possible way of doing epidemiology, " he said.

Instead what was needed was a five year periodic review of each drug

at every stage on the market. " It would clear out the dross, " he said.

 

Also giving evidence were Jenny Hope, medical correspondent at the

Daily Mail, and Lois Rogers, medical editor at the Sunday Times. Ms

Hope denied that drug companies unduly influenced her decisions about

what made a news story.

 

" I don't feel I am being used, but I feel I am a target, " she said. In

deciding whether or not she pursued a story she said her decisions

were based on whether the public should know about it, whether it was

of interest, and whether it would be wrong to keep the information

secret, she said.

 

Both she and Ms Rogers said they needed to know how the regulatory

authority reached its decision in granting a licence to new products.

At the moment this information is bound by a confidentiality agreement

and is not made public in the United Kingdom. " The regulation process

needs to be more transparent, " said Ms Rogers.

 

The BMJ did not submit written evidence to the committee's inquiry so

was not invited to give oral evidence.

 

The transcript of the oral evidence is available at

www.publications.parliament.uk/pa/cm/cmhealth.htm