pe-penadAs many of you probably know, Merck’s pain killer Vioxx turned out to be a bitter pill. Merck pulled the drug in 2004 because a number of reports regarding an increased risk of stroke and heart attack associated with use of the drug. The company has since accepted a $4.85 billion settlement in the U.S., but litigation is still ongoing in Australia and other nations.

As a result of some of the claims coming from the plaintiffs in the Australian suit Merck’s reputation is going from bad to worse.  Of particular note is the disclosure that the company created fake medical journals to publish favorable reports about Vioxx.

From 2002 to 2005, Merck in Australia paid Elsevier, a prominent publisher of scientific journals, to produce what appeared to be a scientific journal called the Australasian Journal of Bone and Joint Medicine. It looked like a standard scientific journal and nowhere was it stated that the publication had been sponsored by Merck. Some of the articles in the bogus journal appeared to have been reprinted from other sources, but the origin of others was questionable. Merck and Elsevier went so far as to create a fictitious editorial board for the journal, using the names of prominent physicians without their knowledge or consent. The company has admitted that they sponsored five other similar  ‘journals’ throughout Australasia.

In April of 2008, The Journal of the American Medical Association revealed that Merck had manipulated data regarding Vioxx before submitting and routinely hired ghostwriters, who are not scientists, to create articles for reputable professional journals. Thus, it is probably not a shock that Merck would take the next logical step of just making up journals to market their products.

vioxx2In the second issue of the bogus Australasian Journal of Bone and Joint Medicine, nine of twenty-nine articles referred positively to Vioxx and an additional 12 articles referred positively to Fosamax, another Merck product.

Copies of the Australasian ‘Journal’ of Bone and Joint Medicine were distributed to between 10 and 20,000 doctors in Australia and this is where it gets insidious. Most general practicioners are not working research scientists and may not have had the eye to distinguish the real deal from a fake. Merck used deception in an attempt to convince clinicians that their product, which has been linked to thousands of strokes and heart attacks, was safe and efficacious.

These people are liars and, due to negligence and probably malfeasance, may be responsible for hundreds of deaths.

I would say that this is surprising, but it is not. Disturbing? Yes. An incredible breach of scientific ethics? Sure. Criminal? Potentially. But surprising? Not at all.

Scientific journals are supposed to be a non-biased, peer-reviewed sources of the latest scientific discoveries. Scientists abide by a code of ethics when it comes to publishing data, but the Merck/Elsevier case isn’t the first instance of questionable ethics in scientific publishing.  The fact of the matter is that until recently it was not common practice to disclose conflicts of interest in published scientific papers. Only in the last two to three years have even the top tier journals began to require authors to disclose conflicting funding sources. Previously, Pharma funded reports were released in journals with no acknowledgement of where the money was coming from.

2650025117_1a8401cbe91Merck is not the only villain in this story. Elsevier, which claims to be “world’s leading publisher of science and health information”, took Merck’s money to create and publicize fake journals. In a statement, the publisher has claimed that all of the people responsible have been sacked and that they are carefully inspecting their stable of journals for other fakes. This kind of skulduggery is in the past. But past or not as the Progressive Librarians Guild attests, “it was a money-making business using the reputation of Elsevier to leverage deceptive pharmaceutical marketing of a harmful product.”

Elsevier is as guilty as Merck and the actions of both companies illustrate a fundamental truth about the pharmaceutical business – we are suckers.

Big Pharma tells a compelling sob story about the costs associated with drug development and the stringent regulatory requirements. Well, maybe those costs would be lower if they didn’t have to pay people to manipulate data, create fake publications or buy off doctors. We’re most likely overmedicated as a culture. There is a ‘cure’ for absolutely everything that ails you conveniently supplied – at a price – from Merck, Bayer or Pfizer. What we need to realize is that these people aren’t in the business of curing us, they’re in the business of selling us more ‘cures’. The regulatory agencies that we pay to protect us aren’t in the business of protecting us, they’re in the business of expediting drug marketing. And the doctors that we pay to treat us are being actively deceived.

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Brisbane trio The Grates latest LP, “Teeth Lost, Hearts Won” is available from The Grates.

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