ICBS Everywhere

Posted May 3, 2009

I have many friends, acquaintances, and students who believe that drug companies make too much money off of the public. In fact, this seems to be the majority view.

I do not have enough information to say they are wrong and I do not want to discuss the P&Ls of those companies, but I am generally of the opinion that it is not that simple. Surely there are deceptive marketing practices and monetary motives, but I am not sure we should be throwing the baby out with the bathwater. Pricing for drugs is a very tricky business; whole governments get involved in pricing and average Americans pick up the slack for research and development by paying high prices for new medications. This R&D, however, produces new, better, and safer treatments every day and it must be funded.

The “Big Pharm” conspiracy view is also a large part of the anti-vaccination movement, which makes me just a little crazy, as most of you know. These idiots claim that pharmaceutical manufacturers and medical practitioners are more concerned about their profits and paychecks than the health of our children. They often equate vaccine makers with tobacco companies. They claim that all physicians get kick-backs and all research is funded by those with a monetary interest in the outcome. There are likely to be bits of truth in all of those statements, but I do not believe the entire medical industry is evil. Once someone adopts a belief like that, it is extremely difficult to convince them that anything positive comes from it, regardless of the evidence one brings to the table or even who brings it.

So, it is particularly disturbing when these companies engages in a seriously unethical act. The job of the science advocate has become much more difficult because that is exactly what The Scientist recently reported has happened.

Merck has apparently paid Elsevier to produce a number of volumes of what appears to be an academic, peer-reviewed journal called the Australasian Journal of Bone and Joint Medicine. The problem is that no such journal exists. It is a marketing tool that contains a selected set reprints and summaries which support Merck products and no disclosure of company ownership. The publishers are listed only as “Australasian Journals”.

This “journal” is not indexed in MEDLINE (PubMed), but an MD flipping through it is unlikely to know the difference without actively searching for its credentials. It is quite obvious from the samples that Merck intended to deceive readers and, according to The Scientist, spokespersons for both Merck and Elsevier referred to the publication as “complimentary”. Complimentary? I understand that they probably distributed the “journal” to doctors free of charge as they would a brochure, but the publication itself lists subscription fees as any legitimate journal would.

Selective reporting of scientific findings results in decisions based on too little information. In the medical world, that can be deadly.

Drug companies have been accused of many such ethically questionable practices in Australia and the UK, including exerting sponsor influence to control who speaks at educational conferences and seminars which claim to be free of industry influence.

However, there is good news. Not everyone was fooled by this and it is not a secret (at least not anymore). It is difficult to keep this kind of facade going for very long without someone noticing, especially when it results in harm (which is highly likely if it has not happened already).

This is an example of a system that works, not a broken one.

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