Ghostwriting documents put online

PLoS Medicine, the medical journal that paired up with the New York Times last month to convince a US court ot unseal documents in a class action suit against Wyeth, put the court documents online this morning. These are raw documents, and so numerous they're tough to sort through.

The documents include internal correspondence, reports, and tracking documents relating to interactions between the pharmaceutical company Wyeth and a medical communications firm, to promote Wyeth’s hormone drugs. These documents show in considerable detail a coordinated and carefully monitored campaign of “ghostwriting” by Wyeth and medical writing companies for a number of products marketed by the company.

Ghostwriting, which involves using medical writers to produce articles that are then nominally authored by an academic not substantially involved in the writing process, has been condemned as an unacceptable practice by medical journals and editors. Nonetheless, the practice appears to persist and by placing all the documents for scrutiny in the public domain, the editors of PLoS Medicine hope that they will help guide the way to identifying reforms that will eventually stamp ghostwriting out.

In order to make these documents available, PLoS Medicine, represented by public interest law firm, Public Justice (http://www.publicjustice.net), and The New York Times intervened in an ongoing court case in which women were suing Wyeth, the manufacturers of Prempro, a hormone replacement therapy. During the discovery process for this case, one of the lawyers representing injured women in the litigation, Jim Szaller of Cleveland, Ohio, had become aware of many documents that laid out in detail the company’s (mostly successful) attempts to publish papers written by unacknowledged professional medical writers in which the message, tone, and content had been determined by the company but the paper was subsequently nominally “authored” by respected academics.

In an accompanying editorial to be published in the September issue of PLoS Medicine, but put online today, PLoS condemns ghostwriting as medical publishing's "dirty little secret" and calls on journals to immediate retract any ghostwritten articles and to ban the authors involved from future publication. Universities are urged to investigate any professor implicated "as a matter of urgency. Shareholders should worry about whether the companies they are invested in could be in for a financil hit.

But more than that, it says, much soul searching is also needed.

Medical journal editors need to decide whether they want to roll over and just join the marketing departments of pharmaceutical companies. Authors who put their names to such papers need to consider whether doing so is more important than having a medical literature that can be believed in. Politicians need to consider the harm done by an environment that incites companies into insane races for profit rather than for medical need. And companies need to consider whether the arms race they have started will in the end benefit anyone. After all, even drug company employees get sick; do they trust ghost authors?