Turn the Page - Pharmaceutical Executive

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Changes in ethics and expectations are driving the way pharma interacts with medical publishers.


Pharmaceutical Executive


When Jim Dougherty Joined Mcgraw-Hill Almost 30 Years Ago, medical journal publishing was different. The days of the "three-martini lunch" were slowly coming to an end. Yet many companies still determined their ad schedules based on relationships. There was also less competition: without DTC or the Internet, journals garnered larger percentages of pharma's marketing mix. Today, Dougherty is group vice president of McGraw-Hill Healthcare Information and president of the Association of Medical Publications (AMP), an organization of publishing firms in the medical field. Like many of his peers, Dougherty has witnessed—and continues to witness—the transformation of the field. The future is bright, he says, but most certainly uncertain.


Instead of just sending in a manuscript, with clinical trial registries, you might have an opportunity to link to the spreadsheets or other individual case reports to offer a more in-depth review. –Jim Dougherty, group vice president of McGraw-Hill Healthcare Information
Today, with pharma-sponsored research under the microscope, medical journal publishing is faced with sorting out issues of credibility and transparency, not only for themselves, but for pharma. To complicate matters, journals must make these changes in a particularly difficult business climate, with increasing scrutiny of the public and the press. To offer readers insight into how medical journals are handling these challenges—and how they affect pharma—Pharm Exec went inside the world of journal editors and publishers.

No More Ghost Stories The recent changes sweeping the editorial offices at journal publishers might be viewed as an extension of the trend to separate real scientific content from marketing information. Some associate that change with the shift the Office of the Inspector General (OIG) prompted in the world of continuing medical education.


Another way conflict of interest disclosures may evolve is to require not just authors, but the writers and editors with whom they collaborate, to disclose any industry relationships relative to a manuscript's content. –Judy Orvos, editor of Contemporary Ob/Gyn
At the base of it, journal editors are trying to do away with publishing ghostwritten articles. "The issue of guest authors and ghost authors has plagued medical journals forever," says George Lundberg, MD, former editor of the Journal of the American Medical Association (JAMA) and current editor of Medscape General Medicine. "Sometimes they're guests, sometimes they're ghosts. It's the editors' job to flesh out the guests and flush out the ghosts."

Just as physicians at CME events are discouraged from presenting promotional slides handed to them by a sponsoringpharma company, researchers can't just sign their name as anauthor. Editors—certainly at primary research, peer-reviewed publications, but increasingly at other journals—have adopted policies that require authors to disclose their conflicts of interest.


First-to-publish has been the criterion for a long time in terms of who gets credit for certain information. The more you disclose during the research process, the more you open up the opportunity for others to get their own results going earlier. –Tim Bacon, president and CEO of PeerView
"Authors are used to it," says Jordana Bieze Foster, editor of Applied Neurology. "Anybody who's published in an academic journal has done it for years."

Nonetheless, says Diana Mason, RN, editor of the American Journal of Nursing, it's still common to find authors who are unsure about—or try to mask—financial ties to healthcare companies. "I don't think the nurses who write for us understand the issues. At least twice, the authors of manuscripts we accepted for publication told us they had no financial disclosures to make. Then, as we were going into production, we discovered they had very serious financial disclosures.


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