Drugmakers don't just compromise doctors; they also undermine top medical journals and skew medical research

Harriet Washington(The American Scholar, Summer 2011)

"[At] the end of 2008…38 members of the pharmaceutical industry vowed to cease bestowing on prescribing physicians goodies such as pens, mugs, and other tchotchkes branded with their names. Some physicians and ethicists had long expressed concern about the 'relationship of reciprocity' that even a pizza or cheap mug can establish between doctors and drugmakers…medical-journal articles are widely embraced as irreproachable bastions of disinterested scientific evaluation and as antidotes to the long fiscal arm of pharmaceutical-industry influence. And yet, 'All journals are bought -- or at least cleverly used -- by the pharmaceutical industry,' says Richard Smith, former editor of the British Medical Journal, who now sits on the board of Public Library of Science (PLoS), a nonprofit open-access group publishing scientific journals…Pharmaceutical advertising impinges heavily on the editorial sphere of medical journals, sometimes with surprising brazenness…journals are utterly dependent upon pharmaceutical advertising…[for] their advertising revenue…medical journals themselves advertise to drugmakers…[in] pharmaceutical-industry publications…to vie for the attentions of Big Pharma [as the top tier of the industry is known]…Pharma’s journal ads tout not only products but also its hundreds of thousands of subsidized 'educational opportunities.' Drug and medical-device makers spend $2 billion annually for more than 300,000 seminars and training opportunities…[down from] $6 billion [in 2000]…Once, conscientious journals did not permit reviewers to take money from drugmakers. But…working as a medical reviewer in the pay of drugmakers has become normalized…even the prestigious NEJM [The New England Journal of Medicine] gave up its search for objective reviewers in June 1992, announcing that it could find no reviewers that did not accept industry funds. Instead, financial disclosure has been pressed into service as a substitute for objectivity. These notices inform the reader which company paid the author, but neither how much nor what nonmonetary relationship the author may be enjoying with the subject of his assessment…

When physician-researchers are paid by the pharmaceutical industry, their medical-journal findings exhibit clear bias in line with the interests of the sponsoring company."

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