In a lawsuit last month against drug manufacturer Merck, the plaintiff introduced a 'peer reviewed journal' strongly supportive of Merck drugs. The ‘journal’, it turned out, was paid for by Merck and its peer-review status was a fraud. Since then, six other journals have been revealed – all falsely identified as peer reviewed. Dr. Peter Lurie of Public Citizen explains how journal publishers and drug companies work together.
BOB GARFIELD: Last month, in the midst of an Australian legal proceeding against the pharmaceutical company Merck, there was an interesting twist. The plaintiff introduced the Australasian Journal of Bone and Joint Medicine, published twice yearly from 2002 to 2005 by the largest medical journal publisher in the world, Elsevier. The journal touted Merck products like Vioxx, but it turns out the supposedly peer-reviewed journal was neither peer reviewed nor an independent journal. It was completely created and paid for by Merck – an ad in journal clothing. In response, Elsevier has launched an internal review and has already found six more faux journals that claimed to be independent and peer reviewed. We should note that it is common practice for legitimate peer-reviewed journals to take big money from big pharma for reprints of articles favorable to a particular drug, then to be circulated to doctors. But according to Peter Lurie, deputy director of Public Citizen’s Health Research Group, what Merck bought was far more than a reprint.
DR. PETER LURIE: This is something that has the size of an actual medical journal article, the appearance of being peer reviewed, but is not.
BOB GARFIELD: So you get a call from a reporter from the journal The Scientist, and he introduced you to the Australasian Journal of Bone and Joint Medicine and, in fact, sent you a couple of issues. What [LAUGHS] did you see?
DR. PETER LURIE: On the face of it, it had many of the elements that might characterize a peer-reviewed journal. But when I looked closer at it, it started to be a little bit more suspicious. For one thing, it was Volume Two, and sometimes that’s a sign that there’s something a little bit amiss, if something is very, very new like this. For another, there were a number of unsigned editorials, which some journals do, but many other do not. And, most strikingly, all of the articles, in one way, shape or form made the case for particular drugs made by Merck. And that’s really what tipped me off.
BOB GARFIELD: Well, what a happy coincidence, an apparent journal bought and paid for by Merck that includes only positive appraisals of Merck drugs.
DR. PETER LURIE: Yeah, what they did was slightly more subtle than that, in the sense that sometimes the name of the Merck drug – and there were two of them, Fosamax and Vioxx – did not appear in the article, but the articles were about subjects that would be helpful to the drug. So, there'd be an article that says, yes, screening for bone mineral density, which might lead to treatment for osteoporosis, is a good idea. And you don't necessarily have to make the connection directly to Fosamax, but a doctor might.
BOB GARFIELD: All right, so there’s actually nothing shocking at all, unfortunately, that a pharma company would undertake this kind of deception. What is shocking is that Elsevier, which is among the most prominent medical journal publishers in the world – it publishes, among other titles, The Lancet - would participate in this petty fraud. Am I right to be so staggered by this?
DR. PETER LURIE: Oh, I think you are. It’s the involvement of the publisher in so conniving a fashion and so deeply cynical a fashion that I think is unusual in this case. And, in addition, the initial refusal of the publisher to acknowledge that there was a problem and initially to refuse to investigate it makes it seem even worse. I mean, these are people who are in principle committed to notions of free speech and the exchange of ideas as being important, and yet when they come upon a very obviously irregular practice within their own ranks, they try to turn a blind eye to it, dismiss it by saying, this happened many years ago.
BOB GARFIELD: What this all comes down to, it seems to me, once again gets back to the fundamental structural conflict of interest that medical journal publishers face. Whether through advertising or through the reprint business, they get most of their revenue, or much of their revenue, anyway, from pharma, the very institution whose research they're attempting to objectively review. Is there ultimately any way around that structural conflict?
DR. PETER LURIE: Well, I suppose if the government or more objective sources were in the business of providing information, writing the journals or other sources that reviewed the journal articles when they came out in ways that were completely isolated from the conflicts of interests that invariably come with industry funding, things might be different. But there’s no question that especially for those journals that rely heavily on reprints, there is a conflict of interest. And it’s undeniable that there would be the temptation to play down findings, particularly disadvantageous to drug companies, those who might go on to buy your reprints, for example. And so, that temptation will always be there, and until such time as we develop a system of providing more objective information to physicians, we're going to have to worry about the veracity of what is being consumed by the doctors.
BOB GARFIELD: All right. Peter, thank you for joining us.
DR. PETER LURIE: Okay, thank you for having me.
BOB GARFIELD: Peter Lurie is deputy director of Public Citizen’s Health Research Group. We contacted Elsevier for a comment, and the CEO of its Health Sciences Division, Michael Hansen, responded with a statement asserting that he had only just learned that Elsevier’s Australian office had, from 2000 to 2005, issued publications made to look like peer-reviewed journals for pharmaceutical clients. Quote, “This was an unacceptable practice and we regret that it took place. We are currently conducting an internal review, but believe this was an isolated practice from a past period in time. It does not reflect the way we operate today. The individuals involved in the project have long since left the company. I have affirmed our business practices as they relate to what defines a journal and the proper use of disclosure language with our employees to ensure this does not happen again.” Hansen concludes: “We have strict disclosure rules in place so that readers are aware of any financial interests behind a specific article or journal or when entire compilation products are created for pharmaceutical marketing purposes.”