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The Best Research Money Can Buy

This article was part of a TED talk by Ben Goldacres, MD

Many health professionals indict direct-to-consumer drug advertising for the public’s willingness and even eagerness to take risky new drugs. As with cigarettes, graphic warnings about the drugs’ side effects –”liver failure, kidney failure, seizures, difficulty breathing, sudden death”–seem to dissuade no one.

Martha Rosenberg, an investigative health reporter, uncovers these and other startling trends in Born with a Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp the Public Health (Prometheus 2012), named in the upcoming American Society of Journalists and Authors 2013 Outstanding Books awards. Her book has been praised by PLOS Medicine and the medical community.

According to Rosenberg, there is another way the drug industry gets potentially dangerous drugs into the nation’s medicine chests. Scratch the surface of many drugs that went on to be discredited, or even withdrawn, and an elaborate “publication plan” emerges, developed by the drug company’s marketing firm. For example, at least 50 articles promoting hormone replacement drugs like Prempro were planted in medical journals by Pfizer’s (then Wyeth) marketing firm DesignWrite, according to documents posted on the University of California, San Francisco’s Drug Industry Document Archive.

“Is There an Association Between Hormone Replacement Therapy and Breast Cancer?” one such article in the Journal of Women’s Health, planted by DesignWrite, is titled–concluding that there is not. A second paper, supplied by DesignWrite and appearing in the Archives of Internal Medicine, is titled “The Role of Hormone Replacement Therapy in the Prevention of Postmenopausal Heart Disease.” A third, also from DesignWrite, in the Archives of Internal Medicine, is titled “The Role of Hormone Therapy in the Prevention of Alzheimer’s disease.” Though the marketing firm’s “science” is egregiously flawed –HT has strong links to breast cancer, heart disease and Alzheimer’s–the papers have not been retracted.

Parke-Davis/Pfizer’s seizure drug Neurontin also benefited from a publication plan, which helped it become the medication of choice for migraines, bipolar disorder and other conditions for which it was not approved. In just three years, Parke-Davis planted 13 ghostwritten articles in medical journals promoting off-label uses for Neurontin including a supplement to the prestigious Cleveland Clinic Journal of Medicine that Parke-Davis made into 43,000 reprints for its reps to disseminate.

Researching, writing and submitting papers to medical journals –and reworking them if accepted–is a time consuming job which drug companies have made into pay dirt. Court obtained documents at the UCSF Drug Industry Document Archive betray drug companies’ elaborate “publication plans” with the names of journals where papers have run, are slated to run, have been submitted and have been resubmitted. The ruse works well for the drug industry, publications–which get thousands of dollars for ads and article reprints–and so-called “authors” who lend their names. But what about patients?

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