hostwriting involves falsely attributing authorship to a person who did
not contribute to the content of a publication. Often, a pharmaceutical company will enlist a medical writer to draft an article that advances the The policy prohibits
marketing campaign for a certain drug. The company will then solicit a prominent
physician to sign on as author. The identity of the true author, who has direct
industry ties, is not disclosed. Ghostwriting essentially serves as a surreptitious
marketing tactic: for instance, a company might commission an article highlighting a particular disease area, examining potential side-effects of competing products, or
promoting off-label uses of a drug in order to enhance the reception of their
products. This practice conceals conflicts of interest and can lead to the
proliferation of dangerous, inaccurate information.1, 2, 3
Ghostwriting is thought to be common: several studies suggest that 9-11% of
articles in biomedical journals have been ghostwritten.5, 6, 7, 8. Because some of these persons who make a
rates were self-reported, the actual prevalence may be much greater. In such
instances, since the industry-paid writers are not credited as authors, their ties to
industry go unreported. Journal editors and readers assume that the authors are
conflict free. This lack of transparency hinders readers’ abilities to interpret the
article and its findings. Ghostwriting is an irredeemable marketing strategy that
threatens the practice of evidence-based medicine.4
Industry ghostwriting should be completely prohibited.
The International Committee of Medical Journal Editors has adopted a set of
authorship principles that can serve as a guide for physicians. Academic Medical
Centers should ensure that their faculty members are aware of proper
authorship principles, and that they know that they are responsible for upholding
*These recommendations come out of an ongoing study by Columbia University's Center on Medicine as a Profession. The researchers will update their
recommendations regularly to incorporate new policies and findings. These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the
prescription drug Neurontin. For more information, contact IMAP at r 212-305-6914.
these standards. Physicians should not be permitted either to produce such articles, or to sign their names to articles to which they have not contributed.
1. Fugh-Berman A. The Corporate Coauthor. Journal of General Internal Medicine. 2005;20(6):546-548.
2. Moffatt, B., Elliott, C. “Ghost Marketing: Pharmaceutical Companies and Ghostwritten Journal Articles.” Persp Bio
3. The Pew Charitable Trusts Prescription Project. Ghosts in the Machine: invisible pharmaceutical industry author-
ship of academic journal articles (report) 2008.
4. Spielmans GI, Parry PI. From evidence-based medicine to marketing-based medicine: evidence from internal indus-
try documents. Journal of Bioethical Inquiry. 2010;7(1):13-29.
6. Flanagin A, Carey LA, Fontanarosa PB, et al. Prevalence of articles with honorary authors and ghost authors in
peer-reviewed medical journals. JAMA: The Journal of the American Medical Association. 1998;280(3):222-224.
7. Mowatt G, Shirran L, Grimshaw JM, et al. Prevalence of honorary and ghost authorship in Cochrane reviews. JA-MA: The Journal of the American Medical Association. 2002;287(21):2769-2771.
8. Wislar JS, Flanagin A, Fontanarosa PB, DeAngelis CD. Honorary and ghost authorship in high impact biomedical
journals: a cross sectional survey. BMJ: British Medical Journal. 2011;343.
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