< Ghostwritten Prescriptions

Transcript

Friday, April 18, 2008

BOB GARFIELD:
And I'm Bob Garfield. This week, JAMA, The Journal of the American Medical Association, published two studies detailing widespread misrepresentation and outright manipulation of medical research.

One concerned the suppression of clinical results by the drug company Merck for its arthritis drug Vioxx, which has been shown to carry a higher-than-disclosed risk of heart attacks for those taking it. The second JAMA article concerned articles about Vioxx printed in medical journals, articles which carried the bylines of supposedly independent third-party authors but which were actually the work of ghostwriters paid by Merck.

This is a pharma industry practice that has been reported before, including on this program, but JAMA's editor-in-chief Dr. Catherine D. DEANGELIS says this was the first time she really had the goods.

DR. CATHERINE D. DEANGELIS:
The reason we published this is because this is the first time that we had enough data that people can go to and check out. And I can tell you that I - [LAUGHS] over the last two days, I've been receiving phone calls and even documents showing that this is a wide practice. People are still being paid to put their name on papers that essentially were already written.
BOB GARFIELD:
But you have acknowledged that you personally were well aware of the ghostwriting issue years ago, and in your editorial you suggest a list of measures that journals can take and researchers can take and the government can take to diminish the possibilities of fraud.

It seemed to me to be a list that should have been institutionalized years ago. It's so obvious.
[BOTH SPEAK AT ONCE]

DR. CATHERINE D. DEANGELIS:
I agree with you. Yes. I agree with you. Try and do it. I couldn't even get some of my colleagues with the wonderful journals to adopt the rule that you must have an independent, if you will, or an academic biostatistician review all the data and do the data analysis.

If someone doesn't want an independent, objective person looking at their data and their analysis, chances are they're trying to hide something. And I don't want that paper, because I don't want to publish it.
BOB GARFIELD:
And what about an affidavit of authorship, where if I'm putting my name on an article I say, yes, this is my work, it is nobody else's work, it hasn't been ghostwritten? How can it be that in 2008 that hasn't long since been the minimum requirement for putting your name atop a journal article?
DR. CATHERINE D. DEANGELIS:
[LAUGHS] We have that rule. But there are, you know, there are 15,000 journals that deal with health care, but they don't all have that rule. We have an authorship form that you have to sign all sorts of things.

These 11 points that I put in as a beginning, many of these we do at JAMA, and some of the other big journals do it. But if everybody would adhere to these, it would be wonderful.

I was at a meeting with a group of us who were trying to work with the academic medical centers and with the medical specialty societies, regarding their role with pharmaceutical companies. And one of the things that looks like the medical specialty societies, I hope, will adopt is that at least their officers cannot serve on speakers' bureaus.

Speakers' bureaus are one example of how the drug company - they pay you to speak. They give you the slides. You can't add or subtract any slide without the permission of the drug company. And they even have the nerve to put their logo down usually in the left lower quadrant of the slide, and they tell you what to say about the illness and their drug.

Now, [LAUGHS] they're not saying it. Their drug salesman isn't saying it. Some opinion leader is saying it. Therefore, it must be true.
BOB GARFIELD:
Trained monkey on the take.
DR. CATHERINE D. DEANGELIS:
Well, I - you said that. I didn't.
BOB GARFIELD:
One of your suggestions concerns peer reviewers, and it made my eyebrows raise, because the suggestion is that anybody who is a peer reviewer of an article submitted to a journal, who then turns around and reveals the contents of the article to a drug company, should be banned from reviewing and publishing articles in that journal.
DR. CATHERINE D. DEANGELIS:
Right.
BOB GARFIELD:
But, yeah! Do you know of cases where that has happened?
DR. CATHERINE D. DEANGELIS:
Yes. It was someone who was asked to review an article for The New England Journal of Medicine. This person immediately called the drug company in question and sent them a copy of the manuscript, which is absolutely supposed to be confidential.
BOB GARFIELD:
You also say that any editor who is a party to allowing for-profit companies to manipulate his or her journal must be relieved of the editorship.
DR. CATHERINE D. DEANGELIS:
Yes. I absolutely believe that. If you knowingly allow a for-profit company to manipulate your journal, then you're going to lose your job, we're going to fire you. The practice, I hope, would stop.
BOB GARFIELD:
What do you suppose the chances are that your recommendations will be embraced?
DR. CATHERINE D. DEANGELIS:
I don't know. All I know is that if we don't do something, patients are going to continue to get harmed. We are all going to continue to be manipulated. It is time for us to take back our profession.

We gave it away, or we allowed it to be taken from us. Now let's take it back. None of this stuff could happen if we didn't cooperate. It's as simple as that.

BOB GARFIELD:
Well, Catherine, thank you very much.
DR. CATHERINE D. DEANGELIS:
[LAUGHS] You're welcome. You take care, now.
BOB GARFIELD:
Dr. Catherine D. DEANGELIS is the editor of The Journal of the American Medical Association.