Intended for healthcare professionals

Letters Key opinion leaders

Thus are our medical meetings managed

BMJ 2008; 337 doi: (Published 15 July 2008) Cite this as: BMJ 2008;337:a789
  1. Adriane Fugh-Berman, associate professor
  1. 1Georgetown University Medical Center, Washington DC, 20057, USA
  1. ajf29{at}

    Outraged key opinion leaders will undoubtedly protest that their opinions are unaffected by industry honorariums and hospitality.1 In some cases this is true. According to an anonymous industry insider interviewed by a publicly funded project I direct (, academic physicians are tracked by industry from early in their careers. Promising young faculty are invited to one on one meetings by pharmaceutical company executives, who interview them about their work and opinions over an expensive meal with excellent wine. Each potential recruit is flattered and well fed. However, only those whose opinions align with marketing messages are taken under a company’s wing, to be financially supported, pampered, and admired while being flown around to speak at academic medical centres and medical conferences.

    Some key opinion leaders are genuinely unaware of the marketing message they are disseminating. A key opinion leader’s opinion that a certain disease is underdiagnosed, undertreated, or more serious than commonly believed can align perfectly with a company’s marketing goals even if drugs are never mentioned. Pharmaceutical companies seek long term relationships with the key opinion leaders whom they recruit—or create. Constant support, treats, and the gentlest of suggestions by one’s “friends” ensure the continued alignment of a key opinion leader’s statements with a company’s marketing messages. It is absolutely essential to maintain the illusion of the key opinion leaders’ independence and integrity.

    Most “experts” are some company’s key opinion leaders. Thus are our medical meetings managed to limit discourse to competing profitable therapies, and to overwhelm non-industry funded voices.


    Cite this as: BMJ 2008;337:a789


    • Competing interests: The author has been a paid expert witness on the plaintiff’s side in litigation regarding pharmaceutical marketing practices.


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