The New England Journal of Medicine (NEJM) and other medical journals are sensitive to the charge that they are unduly influenced by the pharmaceutical industry. Today’s issue contains a typical drug company sponsored study: Modafinil for Excessive Sleepiness Associated with Shift-Work Sleep Disorder. Essentially, the study demonstrated that modafinil is marginally efficacious at best for this indication. But the study’s lead author, whose professorship is endowed by modafinil’s maker, Cephalon put a positive spin on the results. From the abstract:
[M]odafinil… resulted in a small but significant improvement in performance… However, the residual sleepiness that was observed in the treated patients underscores the need for the development of interventions that are even more effective.
In an unusual move, NEJM published an editorial in the same issue entitled Shift-Work Sleep Disorder –The Glass is More Than Half Empty by Dr. Robert C. Basner. He argues that,
This drug is little better than nothing in terms of making [people] less sleepy during shift work at night.
NEJM wants to have it both ways –publishing pro-drug articles that sales reps will be happy to cite, while trying to maintain credibility with the dissenting editorial. If NEJM doesn’t agree with the researchers’ conclusions a better idea would have been to reject the article or insist on changes.August 4, 2005