It may be the worst-kept secret in medicine: pharmaceutical money buys journal influence. What the public has so long suspected has now been demonstrated in a recently published peer-reviewed study. (1) Researchers from Wake Forest University School of Medicine and the University of Florida found that "in major medical journals, more pharmaceutical advertising is associated with publishing fewer articles about dietary supplements." Furthermore, they found that more pharmaceutical company advertising resulted in the journal having more articles with "negative conclusions about dietary supplement safety."
This new study, the first of its kind, specifically looked at pharmaceutical advertising as compared with journal text about dietary supplements. The authors reviewed a year's worth of issues from each of eleven of the largest medical journals: the Journal of the American Medical Association, New England Journal of Medicine, British Medical Journal, Canadian Medical Association Journal, Annals of Internal Medicine, Archives of Internal Medicine, Archives of Pediatric and Adolescent Medicine, Pediatrics and Pediatric Research, and American Family Physician.
The results were statistically significant. . . and embarrassing. Medical journals carrying the most pharmaceutical ads "published significantly fewer major articles about dietary supplements per issue than journals with the fewest pharmads (P < 0.01). Journals with the most pharmads published no clinical trials or cohort studies about supplements. The percentage of major articles concluding that supplements were unsafe was 4% in journals with fewest and 67% among those with the most pharmads (P = 0.02)." The authors concluded that "the impact of advertising on publications" is real, and said that "the ultimate impact of this bias on professional guidelines, health care, and health policy is a matter of great public concern."
Indeed it is. Health care costs are rising and drug profits are enormous. Canadian psychiatrist Abram Hoffer, M.D, Ph.D., says: "We all have to work hard to educate the public about the merits of sane treatment for everyone, where the patient is primary, not Big Pharma." Bo H. Jonsson, M.D., Ph.D., of the Karolinska Institute in Sweden, comments that "Positive reports about the effects of high-dose vitamins have long been ignored by the medical establishment instead of being further examined scientifically."
When patients ask about nutritional treatments, many a family physician has replied, "I've never seen any studies supporting the safety or efficacy of vitamin supplements in my professional journals. The research is simply not there."
Sadly, they are right. And now we know why.
Major medical journals, their editors, and their authors appear to be on the take. Harsh words? Perhaps, but only because the truth is harsh. "On the take" refers to receiving cash in exchange for influence. It is naive to assume that money does not corrupt. Promoting vested interests masquerading as science is wrong and it must be stopped. At the very least, accepting money carries an obligation to account for the source of that money. All medical journals should be compelled to print a full disclosure in every issue itemizing exactly how much money comes from exactly which sources.
Any medical journal that won't disclose has a reason to not disclose. And that reason has nothing to do with public health. It's about private cash. The cash that induces the journals to sway the doctors to persuade the public.
(1) Kemper KJ, Hood KL. Does pharmaceutical advertising affect journal publication about dietary supplements? BMC Complement Altern Med. 2008 Apr 9;8:11. Full text at http://www.biomedcentral.com/1472-6882/8/11 or http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18400092