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Only in a monopoly! This IS how it works. Archive.

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Only in a monopoly! This IS how it works. Archive.

Posted by Walt Stoll on October 27, 2003 at 06:00:34:

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Misty L. Trepke
http://www.searching-alternatives.com

Medical Ghostwriting


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http://www.cbc.ca/consumers/market/files/health/ghostwriting/

Air Date: 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/market/files/health/ghostwriting/




Re: Only in a monopoly! This IS how it works. Archive.

Posted by peterb on October 27, 2003 at 14:02:33:

In Reply to: Only in a monopoly! This IS how it works. Archive. posted by Walt Stoll on October 27, 2003 at 06:00:34:

I read an article about this a little while back; perhaps in the near future, lawsuits against the AMA or institutions deriving benefit from medical ghostwriting will reveal the truth.

Follow Ups:


Re: Only in a monopoly! This IS how it works. Archive.

Posted by Vivian on October 27, 2003 at 18:34:09:

In Reply to: Only in a monopoly! This IS how it works. Archive. posted by Walt Stoll on October 27, 2003 at 06:00:34:

I can't believe it! This is outrageous! I hope that some good comes out of the exposure.

Follow Ups:


Re: Only in a monopoly! This IS how it works. Archive.

Posted by Bliss on October 27, 2003 at 19:50:53:

In Reply to: Only in a monopoly! This IS how it works. Archive. posted by Walt Stoll on October 27, 2003 at 06:00:34:

Walt

This really makes me angry reading about what people like this do for a living. They are paid to cause misery and suffering to those affected by these drugs, through misleading information. If only people could see the human side of the effect that their fallacious information causes to human lives. Or would that even make a difference to them?! (sigh!)

How did the mighty dollar become so much more important than people, Walt?!!! This is something I WILL NEVER understand for as long as I live. How people can kill for money, lie, cheat, cause untold suffering, all in the name of money!

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.

This reminds me of the Nazis who explained away their atrocious actions by saying "We were just following orders, and doing what we were told!"


Follow Ups:


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