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Tuesday, July 25, 2006

PLoS is at it again
PLoS medicine has a great editorial challenging the stranglehold pharmaceutical companies have on medical journals. It's like they exist to pick this fight and I love them for it. They even take on the libertarian canard that advertisement should be protected as "free speech." Ha. The obvious problem being that if you lie as an average citizen, it's not against the law (unless under oath etc.) but when you lie to sell a product, that's called fraud. So, free speech doesn't exactly apply to advertisement, you can't just let them say anything. In fact, you probably shouldn't allow them to say anything that isn't objectively and empirically true (unlike the current practice of allowing puffery in the US).

Anyway, the PLoS editors have it out with the majority of medical journals.

In PLoS Medicine's launch issue in 2004, we declared that we would not be part of "the cycle of dependency that has formed between journals and the pharmaceutical industry" (DOI: 10.1371/journal.pmed.0010022). We set out three policies aimed at breaking this cycle. First, we would not publish adverts for drugs and devices. Second, we would not benefit from exclusive reprint sales to drug companies, since our open access license would let readers make unlimited copies themselves. Third, we would decline to publish studies aimed purely at increasing a drug's market share.

We adopted these policies out of a concern that medical journals have allowed their interests to become too closely aligned with those of the marketing departments of drug companies.
...
And in a recent policy paper in PLoS Medicine, Fugh-Berman and colleagues argued that other medical journals should follow our example and ban adverts for drugs and devices (DOI: 10.1371/journal.pmed.0030130).

The idea of such a ban has, not surprisingly, angered some representatives of the pharmaceutical industry, which gets a return of investment of US$5 for every dollar it spends on advertising to doctors. John Kamp, executive director of the Coalition for Healthcare Communication, a group of advertising agencies and public relations firms representing the pharmaceutical industry, called Fugh-Berman and colleagues' suggestion a "goofy idea" (MMM 23 June 2006). He also said that "PLoS Medicine needs to take a basic course in the First Amendment [the right of free speech in the US Constitution]."


The funny thing is that most lawyers will tell you there are grades of "free speech" the most free being political expression. The most restricted, and long accepted as ok to restrict in order to prevent fraud or misleading information is commercial speech. So, um, Kamp is full of shit, but PLoS doesn't need help proving this.

Drug companies regularly cry "free speech" whenever anyone suggests that their promotional efforts should be curtailed. Billy Tauzin, president of the Pharmaceutical Research Manufacturers of America, went so far as to suggest that such curtailment would be a "human rights abuse". This is nonsense. Drug advertising is often misleading (Ann Intern Med 116: 912–919), and it can potentially distort clinical practice (Circulation 99: 2055–2057). The need to prevent another Vioxx tragedy, in which the "drug marketing got well ahead of the science" (DOI: 10.1371/journal.pmed.0030145), requires us all to think carefully about the net effect upon society of drug adverts. Public health must always come before industry's unfettered "rights." Our recent theme issue on disease mongering has provoked what we believe is a useful debate about when marketing comes before science.


It's a sure sign that libertarians are infesting your society when a drug company can claim advertising is a "human right" and suggest their ability to committ fraud is protected by the constitution. Sorry, but lying to sell a product = fraud. Way to go PLoS, stick it to the man!

Now just go read their table of contents for this month. It reads like a combination of JCI and a turn of the century muckraking journal with titles ranging from, "Questionable Advertising of Psychotropic Medications and Disease Mongering" to A New Mouse Model to Study Acquired Lymphedema" to "The 'Ultimate Prize' for Big Tobacco: Opening the Chinese Cigarette Market by Cigarette Smuggling".

They're even good about publishing letters from their critics of the disease mongering issue. I felt they did come off a bit rabid, but they also pointed out a whole lot of bullshit that's going unchallenged, and I think that's some of the best science (as you may have noticed).

2 Comments:

Buck Mulligan said...

I've known John Kamp for a long time; he's an information industry lawyer. They're always crying "First Amendment" when it threatens the bottom line!

Anyway, there are many categories of speech that can be regulated. Commercial speech occupies a middle space, and other forms (such as threats, libel, etc) can be more heavily regulated. Commercial speech can be regulated where it serves a substantial government interest and the regulation is tailored to serve that interest.

1:00 PM, July 25, 2006

 
Rev. Dr. said...

Thanks, I needed a lawyer to say that in an accurate fashion. All I know is that the idea of absolute free speech is a myth.

Lots of speech is criminal, including the type Kamp is advocating. And telling them they can't lie and mislead to sell their wares is hardly a "human rights violation."

6:13 PM, July 25, 2006

 

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