Cassper the friendly ghostwriter

Recent revelations of pharma companies arranging for the publication of ghost-written articles aren't surprising to Health Business Blog readers --it's something I've been writing about for years. It is interesting though, how the media tend to place the blame squarely on the drug companies for such activities. And to be sure it is hard to give Glaxo a pass when they use a name like CASSPER to refer to their initiative to boost Paxil!But there is plenty of blame to go around, and one view is that the drug companies were treating the medical profession and journal publishers the way they deserve to be treated.Here's how it worked:

• Pharma company salespeople approached doctors to offer help in writing and publishing articles favorable to their product
• Pharma hired ghostwriters to compose articles based on their own outline
• Doctor signed off on the article and submitted it for publication
• Journal sent article for peer review
• Journal accepted article and published it
• Pharma bought reprints and circulated to physicians for marketing purposes

Clearly there is something fishy about what pharma's doing here, and without them funding the enterprise it wouldn't occur. Nonetheless, doctors shouldn't be putting their names on ghostwritten articles, peer reviewers should be finding problems with the articles and rejecting them or calling for revisions, and journals shouldn't publish such stuff.Journals that published these articles have the most to answer for in my opinion. Keep in mind that the pharmaceutical industry is a major reason these journals thrive in the first place. After all, pharma companies:

• Write many of the articles (ghost-aided or not)
• Buy the majority of advertising
• Purchase subscriptions
• Purchase reprints --sometimes hundreds of thousands of copies of a single article as was the case with an infamous Vioxx reprint

Frankly I'm surprised medical journals have been able to retain so much prestige.If anything the situation reminds me of the scandal involving bias on the part of equity analysts. A lot of individual investors took what they said at face value, even though the fix was in. Readers of journals may be making the same mistake.