BMJ  2003;327 (9 August), doi:10.1136/bmj.327.7410.0-g

Editor's choice

What's your price?

About six months ago a woman representing a drug company rang me and said that she would take me to "the restaurant of my choice" if we would change our policy on economic evaluations and consider a paper that her company had sponsored. She stopped short of offering to go to bed with me, but I was surprised by her crassness. "Are you trying to bribe me?" I asked. "No," she answered brightly, "just being nice."

Perhaps I shouldn't have been surprised. Caroline White, chair of the Guild of Health Writers, describes how guild members were invited to attend an "exclusive preview" of laser eye technology where they could "discuss free treatment in exchange for editorial features" (p 348). On another occasion members were invited to a conference on cancer, but places would be free only if the journalists could guarantee copy both before and after the conference.

Such invitations do not meet the code of practice of the Institute of Public Relations, but the public relations agencies are desperate for business and their clients for editorial coverage. "A 'message' reported in the news media is eight times more likely to be trusted than an advertisement," reports White.

Better than having a journalist write a piece on your product is to have someone you pay to ghost write the piece. Minerva (p 350) picks up on an intriguing article from the British Journal of Psychiatry (2003;183: 22-7[Abstract/Free Full Text]) that compares articles on the antidepressant sertraline coordinated by "a medical information company" and those produced in the usual way. The authors, David Healy and Dinah Cattell, were able to identify the articles coordinated by the company because of a document that was obtained in legal proceedings. The document was produced for Pfizer, the manufacturers of sertraline.

The company—Current Medical Directions from New York—"writes up studies, review articles, abstracts, journal supplements, product monographs, expert commentaries and textbook chapters." It obviously does its work well, as its articles were roughly five times more likely to be cited than control articles.

The gains to be had from marketing your product hard are illustrated well by a press release from "Linda Liu, healthcare analyst at Frost and Sullivan" entitled "Critical success factors for the sexual dysfunction medication market." The United States market, writes Liu, is "experiencing a surge of interest and is expected to grow significantly from its current $1.9 billion status in 2002. Advertising, a flux of new entrants, expansion of treated indications, and growth in the sexual dysfunction prevalent population (sic) are driving demand for sexual dysfunction medication." Invest now, seems to be the message. There may be more money in sex than tobacco.

These pieces come to hand as we publish many responses to our theme issue on doctors and drug companies (p 341). Several respondents want us to grow up and recognise that everybody has conflicts and agendas. Maybe I should have gone to that restaurant.

(rsmith{at}bmj.com)

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