The use of “ghostwriters”—professional writers who assist non-writers to write a book or article and who are paid for their work but receive no public credit for their efforts—hence the “ghost” in the term—are widely used. It is common for professional sports stars, politicians or actors to utilize ghostwriters when writing their Great American novel. Football players play football: they don’t write for a living. Politicians schmooze: they don’t write for a living. And actors act, not write. So it’s no surprise that when an actor or athlete “writes” a book, he or she doesn’t do it alone. The player, star or politician provides the material, anecdotes and subject expertise and the ghost provides the writing ability. And together, they produce a polished work.
The value of ghostwriting has apparently not been lost on the pharmaceutical industry either. Except that in the instance detailed in an article published today in the New York Times, the only contribution made by the drug company to ghostwritten medical articles designed to increase the sales of its drugs was money.
In court documents just made public and reported on by the New York Times the drug company Wyeth utilized paid ghostwriters to generate articles that appeared in 18 medical journals that emphasized the benefits and downplayed the potential dangers of Wyeth’s hormone replacement therapies. These articles bolstered the status of the drugs and helped generate a consensus among physicians that eventually drove the sales of Premarin and Prempro to nearly 2 billion dollars in 2001. Sales of the drugs crashed in 2002 when a study on hormone therapy was stopped after researchers found evidence that the drugs may increase the risk of invasive breast cancer, heart disease, and strokes.
According to documents reviewed by the New York Times (and that can be found here) in one instance Wyeth hired the medical communications company DesignWrite from Princeton, New Jersey to assist it with the publication of at least one article about Wyeth’s hormone replacement therapies, Premarin and Prempro. The article, published in 2005 in the Journal of Reproductive Medicine, described hormone drugs as the “gold standard” for treating hot flashes, and while not denigrating other therapies, did not support them. DesignWrite generated an outline of the article and then found a physician to be “lead author” for the article. Once the physician had agreed to be “lead author,” DesignWrite drafted the entire article and sent it to the physician for review. According to the Times article, the physician had only a single edit in the entire draft generated by the communications firm. Undisclosed in the article was that DesignWrite had generated the entire article (minus the single correction) and had charged Wyeth $25,000.00 for their assistance. In 1997 before this article had been written, DesignWrite proposed to Wyeth a 2 year program that would include 30 articles to be published in the medical literature.
“It’s almost like steroids and baseball,” said Dr. Joseph S. Ross, an assistant professor of geriatrics at Mount Sinai School of Medicine in New York, who has conducted research on ghostwriting. “You don’t know who was using and who wasn’t; you don’t know which articles are tainted and which aren’t.”
A spokesman for Wyeth maintained that the articles were scientifically sound, and that the content had met the standards for publication in the medical journal. According to the Times, Elsevier, the publisher of some of the journals said it was “disturbed” by the allegations of ghostwriting and would look into the matter.