Editorial: Drug companies and medical research

Published in The Hindu on July 15, 2005

By calling a spade a spade, Richard Smith, the former editor of the British Medical Journal for 25 years, has turned the spotlight on how medical journals, peer-reviewed journals included, make money by publishing scientific papers that are little more than marketing tools for pharmaceutical companies. The attack on pharmaceutical companies and journals that depend on them for revenue has brought to the fore their symbiotic relationship that has made a mockery of the reverence attached to papers published in journals. Mr. Smith’s is not a lone voice; many former editors of medical journals have aired similar views in the past. Despite the flak, the drug companies continue to dress up papers so that clinical trial results are favourable to their interests. This they do by building bias into the system right from the beginning of the trial. They conduct trials against a treatment known to be inferior, test their products against placebos or use a low dose of a competitor drug, do selective reporting of results, conduct multi-centric trials, and publish in many journals only those results that are favourable to them. While peer-reviewed journals sometimes detect such biases, the machinations of drug companies often escape their watchful eyes.With all the pitfalls, journals cannot ignore publishing major clinical trial results — it increases their popularity and more importantly brings revenues; thousands of dollars worth of reprints are bought by drug companies for publicity campaigns. Researchers are in a predicament; but for company funding, they will hardly get to do clinical trials. Such funding often comes with strings attached — companies call the shots and researchers have no role to play in trial design or data reporting. One way to sever the nexus between drug companies and researchers is to provide the latter more public funds for clinical trials. It is well-established that trials funded by other sources are largely unbiased. Ensuring that papers are published only if authors controlled the right to publication and insisting that only the results of trials that are registered are eligible for publication, as decided by the International Committee of Medical Journal Editors (ICMJE), will go a long way in ending the undesirable practice and making the drug companies more accountable.