Misleading research is often published in major medical journals and doctors are lending their names to it, the editor of the Journal of the American Medical Association said.
Doctors, regulators, publishers and others are all taking money, information and small presents from pharmaceutical companies and being influenced in the process, said Dr Catherine DeAngelis.
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"It goes for all of us," DeAngelis, whose journal is influential nationally and globally, said in a telephone interview.
Her journal, commonly known as JAMA, published a paper accusing Merck and Co. of suppressing data that showed its now-withdrawn pain drug Vioxx was harming patients, and saying that academic researchers had lent credibility to the company's allegedly manipulated research by putting their names on the work.
Merck and the independent researchers have denied this and say the journal is mistaken in this case.
But DeAngelis said there is a "gigantic" problem of drug companies influencing doctors and patients. Her journal presents the Merck case as a specific example of one facet of the problem.
"We have given away our profession and we have got to take it back," she said.
Drug companies spend millions of dollars on promotional materials, from pens to prescription pads. They pay for doctors to travel to seminars, often in exotic places, to learn about drugs.
They set up elaborate booths at medical meetings and send articulate drug representatives and "detailers" to pay personal visits to doctors.
Careful watchdogs
"Physicians in private practice shouldn't even take a pen from anybody, let alone pizza lunches or whatever," DeAngelis said.
In addition, the companies fund many medical studies. Government funds are usually only used for the first stages of research - the rest is left to companies who conduct studies to seek licensing for various drugs. DeAngelis said there is no way around this.
But, she added, "The editors (of medical journals) have to be very, very careful watchdogs over what we publish."
The influence does not usually amount to outright bribery, DeAngelis added. "We just have to be more careful, all of us, and insist that we are not going to be hoodwinked by them, fooled by them," she said.
"The physician should learn from other physicians, not from some detail person," DeAngelis said.
Consumers Union agreed
"Pharmaceutical companies need to get out of the business of 'ghostwriting' articles for medical journals," Dr John Santa, a medical consultant to Consumers Union, said in a statement.
One of the studies in the journal shows that Merck researchers mostly wrote one of the studies alleged to have shown the higher risk of deaths, but later added the names of Alzheimer's experts Dr Leon Thal of the University of California, San Diego, and Steven Ferris of New York University.
Ferris denies his name was simply pasted onto the study and said he was involved in both the research and in writing the article. "I am livid about it," he said in a telephone interview.
Thal died in a plane crash in 2007, but was a prominent Alzheimer's expert who would have been able to catch any errant data showing a risk of deaths or stroke, Ferris added.
"We did participate in the study and we did participate in the process of producing the final manuscript," Ferris said. – (Maggie Fox/Reuters Health)
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