Conflict of interest
Healy says that the pharmaceutical industry has a pervasive influence on academic medicine. Most of the authors published in the Journal of the American Medical Association have received research funding from, or acted as a consultant for, a drug company. Major journals have expressed concern at the ghostwriting of and conflicting interests surrounding pharmacotherapeutic studies, especially in psychiatry.
Medical ghostwriting occurs when anonymous scribes with scientific backgrounds are paid to produce reports for publication as if written by better-known experts. Healy estimates that 50 per cent of literature on drugs is ghostwritten/abnormally written. This is an estimate by Healy offered under questioning before the UK House of Commons Health Select Committee investigation. It is based on extrapolation of a 57% figure from a published paper by Healy and Cattell reliant on hard evidence on a set of papers on Zoloft which came to light due to legal discovery, to the wider field of drug studies in top quality journals. In his thesis, Healy states that ghostwriters write on research given to them by drug companies, which want both positive results and positive research; therefore ghostwriting is biased from the beginning.
Healy allegedly encountered ghost writing involving Wyeth's SNRI Effexor. Healy attended a meeting promoting Effexor, and was offered for his approval a draft article that had been written for him. He left it intact, but made two additions. One contradicted Wyeth's claim that Effexor got patients fully well compared to patients on other SSRIs and another stated that SSRIs could make some individuals suicidal. The article had already been submitted to the Journal of Psychiatry and Neuroscience before Healy saw it again; both of his additions had been removed. In response Healy removed his name from the article.
In the preface of his book Let them Eat Prozac Healy describes the need for a "new contract between society and the pharmaceutical industry – a contract that will require access to the raw data". Healy suggests a new division that can manage the hazards that only becomes visible after products are launched. This new division would be separate from the regulatory bodies and pharmaceutical companies. In "Interface between authorship, industry and science in the domain of therapeutics" a paper of 2003 for The British Journal of Psychiatry, David Healy notes that
"The literature profiles and citation rates of industry-linked and non-industry-linked articles differ. The emerging style of authorship in industry-linked articles can deliver good-quality articles, but it raises concerns for the scientific base of therapeutics … If ghostwriting is an inevitable feature of modern scientific writing, the potential availability of the raw data would do more to ensure a correspondence between those data and a published end result than could be achieved by any other mechanism".
