Buying science for profit

Where did doctors get the idea that Vioxx, Trovan and Baycol were safe and the benefits of Prempro, Neurontin and bisphosphonates outweighed their risks? From research published in medical journals written by drug companies or drug-company funded authors. Many drugs that went on to be discredited, or even withdrawn as risks were promoted by the drug company’s marketing wing. 

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.

Another example is Parke-Davis/Pfizer’s publication plan to make seizure drug Neurontin become the prescribed drug 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.

Documents show drug companies’ “publication plans” for their products–elaborate grids with the names of journals where papers have run, are slated to run, have been submitted and have been resubmitted, the marketing firms apparently not taking “no” for answer. Do the journals know they are part of such machinations?  Some blame journals for publishing marketing disguised as science.  In addition to ad sales, journals can earn hundreds of thousands of dollars from reprints of articles that the drug companies want to disseminate. Medical and scientific journals have tried to improve their disclosure of authors’ financial links to industry–but not too hard. Often the disclosures are relegated to a barely readable paragraph linking authors identified by initials not names to 60 or more drug companies. Worse, the disclosures don’t appear in abstract databases like PubMed but are hidden behind a financial firewall available only to paid subscribers who have access to the full articles. But planting drug industry-funded papers that extol new drugs or smooth over safety concerns is too lucrative for journals or drug companies to quit.

TNF (tumor necrosis factor) blocker drugs such as Humira, Remicide, Enbrel and Cimzia are the drug industry’s new profit center now that so many blockbuster pills have gone off patent.The conditions such biologic drugs treat–rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis–are rare but drug companies now call them underdiagnosed and offer quizzes to help patients self-diagnose.  Papers written by drug industry-funded authors are appearing in journals to minimize the many dangerous side effects that accompany TNF blockers because they suppress the immune system. Recently research by drug industry-funded authors has appeared in medical journals to dispel data linking TNF blockers to increasing incidences of hospitalizations, malignancies, cardiovascular events and Herpes zoster.

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