Intended for healthcare professionals

Feature Reporting of research

Ghosts in the machine

BMJ 2011; 343 doi: (Published 06 December 2011) Cite this as: BMJ 2011;343:d7860
  1. Rachel Hendrick, doctoral researcher, University of Edinburgh and BMJ, Edinburgh, UK
  1. rachelhendrick{at}

Ghostwriting in medical publishing on behalf of big drug companies has a long history, finds Rachel Hendrick, and oversight of the practice has its problems

The medical writing industry is the subject of much heated debate. Some consider medical writers to be skilled communicators of knowledge; others argue that they are merely marketing puppets working at the behest of drug company masters.

Industry documents released during litigation show that some drug companies have hired medical writers to anonymously develop articles that portray their product favourably and have then paid academic physicians or scientists to be named as authors. This practice has been termed “ghostwriting.”

Lisa Bero, professor of health policy and clinical pharmacy at the University of California explains: “The main problem with ghostwriting is that you don’t know who is accountable for the research reported in the article. Knowing who will stand up for the integrity of the data is critical to trusting a scientific publication.”

Others suggest that the employment of professional medical writers gives the drug industry greater control over what is written about its products. “Ghostwriting is pernicious because it takes marketing and disguises it as science,” says Paul Thacker, a former investigator for Charles Grassley (senior US senator for Iowa) who researches medical conflicts of interest. “This completely undermines the foundation of science, meaning that any attempt at understanding is skewed in a marketing direction.”

Examples of ghostwriting include GlaxoSmithKline (GSK), then known as SmithKline Beecham, who employed a medical writing agency to produce articles promoting their drug paroxetine (UK brand name Seroxat; US brand name Paxil), a selective serotonin reuptake inhibitor antidepressant drug, in a publication programme named Case Study Publications for Peer Review (or, aptly, CASPPER, for short).1

Company documents show that medical writers were hired to assist in preparing material …

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