To cap off a week on this blog that featured several posts about drug industry influence on medicine or on journalism, here are excerpts of Dr. Carl Elliott’s column on the Hastings Center’s Bioethics Forum:
“…consider the indignant letter posted recently in PLoS Medicine by an attorney for Wyeth Pharmaceuticals. Apparently, Wyeth is upset about an article by Adriane Fugh-Berman titled “The Haunting of Medical Journals: How Ghostwriting Sold ‘HRT’.” Drawing on internal documents made available to her when she testified as an expert witness against Wyeth, Fugh-Berman describes how the company used ghostwritten journal articles to promote Prempro, its hormone replacement therapy.
So what is the crime Wyeth is so worked up about? That Fugh-Berman – who writes in her introduction that she got access to the documents through her work as a paid expert witness in litigation against Wyeth, and also discloses that fact in her competing interests statement – did not specifically state that she is still working as an expert witness. Yes, that’s the crime. Not the breast cancer, not the heart disease, not the strokes or emboli linked to Prempro. The crime is using the incorrect verb tense.
Wyeth, of course, is the company that became notorious in the 1990s for covering up the lethal side-effects of its diet drug, Fen-Phen, which was linked to valvular heart disease and primary pulmonary hypertension. The bill for the Fen-Phen disaster is currently $13 billion and counting. In 2009, Wyeth was acquired by Pfizer, a three-time felon which paid out $2.3 billion last year to settle criminal and civil allegations that it illegally marketed Bextra, Geodon, Zyvox and Lyrica. The Pfizer settlement was the largest health care fraud settlement in U.S. history and the largest criminal fine of any kind. And now that Wyeth is being sued yet again – this time, by 14,000 patients who developed breast cancer while taking Prempro – it has apparently decided to take a lesson from Wall Street. Not only is Wyeth upset about Fugh-Berman’s expert testimony, it is angry that PLoS Medicine joined with The New York Times to force the company to make the ghostwritten documents public.
It is worth remembering exactly what we owe to people like Fugh-Berman, and to organizations like PLoS Medicine. Most physicians are terrified of the pharmaceutical industry, and most medical journals are financially dependent on it. As a result, the extent of industry wrongdoing was largely hidden from the public for years. That began to change when expert witnesses who had testified against the pharmaceutical industry began to make their findings public.
In a just world, the complaints of Wyeth about its unfair treatment at the hands of a single academic physician would be met with the ridicule that they deserve. Instead, these complaints will probably just frighten physicians even more. And that, I suspect, may be the real purpose of the letter: to intimidate anyone who might be thinking of testifying against them.”
P.S. Do you think this topic will be discussed at the Pfizer-funded National Press Foundation journalism “training” sessions being held twice yet this year?
How about a discussion about the BMJ journal editors accusing Pfizer – as the New York Times put it – “of undermining the integrity of evidence relied on by regulators, doctors and patients.” This after an analysis in the BMJ concluded that a Pfizer antidepressant was “overall an ineffective and potentially harmful antidepressant.”