Price of independence

Independence is a journal's most precious asset, and independence means financial independence. “He who pays the piper calls the tune.” So to be able to play multiple tunes a journal needs multiple sources of income—and drug advertising is one of the most important and profitable. The beauty of drug advertising is that there are many companies who want to advertise in a journal that has a wide circulation. This means that none of them alone has the power to influence the journal.

Advertisers may huff and puff in response to articles that upset them, and they may for a while take away their advertising. But the journal doesn't depend on any one advertiser—and so can ignore the protests. Furthermore, the multiple advertisers keep a close eye on each other. If an advertiser breaks any of …