Lack of quality control in closed-access journals

A PR agency was able to place promotional articles as science for years on behalf of a pharmaceutical company

Wyeth is a pharmaceutical company belonging to the Pfizer group. It employed a PR firm, DesignWrite, which managed to get numerous drug advertisements through the peer-review system that supposedly ensures quality in scientific publishing, and placed them in expensive closed-access journals as supposedly scientific articles.

This succeeded, among other things, because the advertising texts were not formulated too platitudinously and at least formally maintained the appearance of scientific work. To this end, the PR agency mainly wrote articles summarizing the results of real studies on hormone replacement therapy for menopausal women and apparently drawing new conclusions from them. They downplayed dangers such as a higher risk of breast cancer and praised positive effects such as an alleged reduction in the likelihood of developing dementia, which the material did not show. In fact, later studies have shown that hormonal drugs actually increase the risk of dementia in elderly patients.

For these texts, the PR agency looked for physicians who were willing to put their names under them. It has not yet been proven that money was involved. However, the pressure to publish in the academic field is sometimes so great that it is quite conceivable that the expansion of their publication list was reward enough for the straw men. The Elsevier journals American Journal of Obstetrics and Gynecology and International Journal of Cardiology, among others, fell for this combination of advertising text and name between 1997 and 2003.

The practice came to light as a result of a large-scale publicly funded study and subsequent claims for damages from over 14.000 American women who developed breast cancer after their doctors prescribed the hormone drugs Premarin and Prempro, marketed by Wyeth, for hot flashes and other menopausal symptoms. The two drugs generated about $2 billion in sales for the pharmaceutical company in 2001 alone.

As part of such a civil lawsuit, Wyeth had to disclose a four-digit number of internal emails, memos and contracts last July. Adriane Fugh-Berman of Georgetown University Medical Center in Washington DC looked closely at these documents and has now published her findings in the open-access journal PLoS Medicine.1 The publication sparked a debate about scientific ghostwriting, to which the journal Nature, part of the Holzbrinck publishing group, also contributed on Tuesday.

The debate is also perceived as excessive because Pfizer continues to have such texts produced. However, the company said, care has now been taken to ensure that nominal authors are included and that "Contributions" of unnamed authors in such essays "explained" were. Group spokesman Christopher Loder also tried to justify the Premarin and Prempro promotional articles by pointing out that the texts had gone through the peer review process.

From this indisputable fact, however, another conclusion can be drawn – namely, that this method is now so weak that it can no longer sufficiently guarantee the integrity of texts. This is partly due to the fact that the evaluators are only paid in exceptional cases by the publishers, who achieve monopoly returns of up to 40 percent, which is why many scientists participate only once per journal, in order to then fish for another publication for their CV, with which they do the same.

Also, the Harvard professor of medicine, Thomas P. Stossel defended the ghostwriting phenomenon, which medical ethicist Leemon McHenry has found goes far beyond the incidents that have now come to light. The editor-in-chief of the journal Current Opinion in Hematology says that due to a lack of time and skills, many physicians are dependent on professional service providers to write texts for them. In his opinion, this is just as legitimate as the use of speechwriters by politicians.

Leave a Reply

Your email address will not be published.