What is medical ghostwriting ? Answers to a relevant issue in medical ethics


What is medical ghostwriting? According to the Wikipedia definition:

With medical ghostwriting, pharmaceutical companies pay physicians or scientists to produce papers in medical or scientific journals on the outcomes of new medications. Medical ghostwriting has been criticized by a variety of professional organizations representing the drug industry, publishers, and medical societies, and it may violate American laws prohibiting off-label promotion by drug manufacturers as well as anti-kickback provisions within the statutes governing Medicare. Recently, it has attracted scrutiny from the lay press and from lawmakers, as well. It is permitted at some institutions, including the University of Washington School of Medicine, while it is prohibited and considered a particularly pernicious form of plagiarism at others, such as Tufts University School of Medicine.

Most pharmaceutical companies have in-house publication managers who may either manage the writing of publications on the company’s drugs by a team of in-house medical writers or contract them out to medical communication companies or freelance medical writers. Reprints of the articles can be distributed to doctors in their offices or at medical meetings by drug company reps in lieu of product brochures, which might be illegal, if they were to otherwise advocate use of the drug for nonapproved indications or dosages. Payments to medical ghostwriters may be augmented with consulting contracts, paid trips to teach continuing medical education courses, or grants. The academics or doctors are known as "KOLs" ("Key Opinion Leaders") or "TLs" ("Thought Leaders").

What has been published in medical journals about this practice?

1. What Should Be Done To Tackle Ghostwriting in the Medical Literature? PloS Medicine. February 2009

Matt, from his blog "Prescribing advice for GP’s" summarizes the points of view:

"Three viewpoints are presented in the article. One contributor suggests that ghostwriting is scientific misconduct. A second contributor suggests that the extent of ghostwriting needs to be quantified and the impact assessed. Finally, it is suggested that ghostwriters can make a legitimate contribution but concealing the contribution is dishonest and unacceptable."

2. Guest Authorship and Ghostwriting in Publications Related to Rofecoxib. JAMA, 2008. This article triggered a story at the business section of the NYT.

3. Prominent journals have started their own "ghostbusting". ‘Ghostbusting’ at Blood. Blood. January 2009

"We invite Blood readers and ASH members to join us in "ghostbusting" by refusing to serve as authors of papers they did not actually write or to which they did not substantially contribute, and by insisting that important contributions of all participants, whether from academia or the pharmaceutical and biomedical research industries, be fully acknowledged. "

"The Art of Medical Writing", a video published by PharmedOut.

Illustrated Psychopharmacology Lectures in Your Inbox

  • Mechanisms of action, adverse effects and indications of psychotropic medications.
  • Concise and illustrated presentations. 
  • Practical tips for mental health professionals.




Are you a visual learner interested in learning psychopharmacology? Click here to get our videos