Intended for healthcare professionals


Ghostwriting: the importance of definition and its place in contemporary drug marketing

BMJ 2016; 354 doi: (Published 30 August 2016) Cite this as: BMJ 2016;354:i4578
  1. Alastair Matheson, independent consultant
  1. Toronto, Canada
  1. amatheson{at}

Alastair Matheson describes how the pharmaceutical publications industry seeks to legitimise ghostwriting by changing its definition while deflecting attention from wider marketing practices in academic publishing

During the past decade, the pharmaceutical publications trade has campaigned to persuade medicine, journals, ethicists, and the media that it is opposed to ghostwriting. Yet industry practices have changed little, and commercial drafting of clinical trial reports, consensus statements, and reviews that are authored by recruited academics remains routine. Here, I show that industry’s opposition is based on a redefinition of the term ghostwriting that obscures the continued, widespread use of the practice as originally defined in medical journal literature. I also argue that the ghostwriting debate has deflected attention from the broader set of strategies through which marketing influences medical publications. The use of writers, regardless of whether they are called ghosts, is just one of several options for building commercial perspectives into academic literature, then spinning their attribution to strengthen credibility.

Rebranding of ghostwriting

Outside medicine, a ghostwriter is “a person whose job it is to write material for someone else who is the named author.”1 Drug companies and their agencies use writers to develop articles for academic authors, and in the 1990s and early 2000s this was commonly understood as ghostwriting, both by journal editors and the pharmaceutical publications trade.2 3 4 5 But today, the trade promotes an alternative definition, whereby writers are not classified as ghosts if they are named in a footnote.

The International Society for Medical Publication Professionals, a trade association, states: “Ghostwriters are individuals who contribute substantially to a medical publication but do not appear on the byline and are not acknowledged for their contribution.”6 The Global Alliance of Publication Professionals, a trade advocacy unit, states: “A ghostwriter is someone who writes a paper, but whose …

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