To the Editors of the Journal of Health Economics: Have You No Shame?

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http://ahrp.blogspot.com/2008/10/to-editors-of-journal-of-health.htmlTo the Editors of the Journal of Health Economics: Have You No Shame? In 2004, Dr. Richard Horton** described medical journals as "information laundering operations for the pharmaceutical industry.” [1] We thank Dr. Richard Smith* for alerting us to a little known case of gross editorial misconduct--a case that corroborates Dr. Horton's verdict.Dr. Smith calls this case, involving the editors of Journal of Health Economics (JHE), "nothing less than a ripping yarn." See his commentary on the BMJ blog: [Link] This journal is read worldwide and has high citation impact factors in both Economics and Health Policy and Services. This means that whatever claims are made in its pages--whether valid or not--are likely to be highly influential.Three of the five editors of the Journal--Joe Newhouse, Richard Frank, and Tom McGuire--are Harvard professors.The editors suppressed a well-reasoned and documented paper challenging a 2003 article published by the JHE in which a study by the Tufts Center for the Study of Drug Development claiming that it cost $802 million (in 2000 dollars) to bring a new drug to market is quoted. This claim, has been used by the pharmaceutical industry to justify its inflated prices for new drugs.Dr. Donald Light and Dr. Rebecca Warburton submitted a paper to the journal in 2004, arguing that the claim was unfounded. They made five points about the data and methods of the DiMasi et al. paper, and then discussed issues of potential conflict of interest due to industry funding. Although funding from pharmaceutical companies was declared on its website, this information was not disclosed to readers of the Journal. Drs. Light and Warburton sent the editors of the JHE evidence of how competing interests strongly influence study findings. Drs. Light and Warburton provided the details of JHE editorial misconduct. They believe that the editors of JHE have “violated … almost every ethical standard established for editors.” Act One: Commercial Influence Deleted Act Two: Protecting the Authors Act Three: Eviscerating the Rejoinder Act Four: A Strike for Academic Freedom? Act Five: Covert ActionAfter reading about the sordid underhanded behavior of these editors in a protracted drama in 5-ACTs, we can only hope that someone in a position of authority--preferably authority over the public purse strings--will confront duplicitous academic gatekeepers who have shamelessly betrayed the public trust.Of note: the article appended below, by Drs. Light and Warburton, first appeared---then disappeared--from the Harvard Health Policy Review website, a student paper, under duress from Harvard editors of the Journal of Health Economics. See: [Link]The article has just been reposted with a note. See: [Link] . Someone needs to confront the academics who have violated ethical standards as they sullied the integrity of science, and demand: "Have you no sense of decency? At long last, have you left no sense of decency?"*Dr. Smith is the former editor-in-chief of the British Medical Journal (1979-2004) **Dr. Horton is the editor-in-chief of The Lancet.ReferencesHorton R. The dawn of McScience. New York Review of Books. 2004;51(4):7-9.---------HARVARD HEALTH POLICY REVIEW Vol. 9, No. 1, Spring 2008, pp. 46-55 In Focus Ethical Standards for Healthcare Journal Editors: A Case Report and Recommendations Dr. Donald W. Light and Dr. Rebecca N. Warburton[Dr. Donald W. Light is a Fellow at the Center for Bioethics at the University of Pennsylvania and Professor of Comparative Health Systems and Policy in the Division of Social & Behavioral Medicine at the University of Medicine & Dentistry of New Jersey. Dr. Rebecca N. Warburton is an Associate Professor and Health Economist as well as a Michael Smith Foundation for Health Research Scholar, School of Public Administration.]Unfair and biased editing is not new. Over many decades, authors have occasionally suffered from prejudice, favoritism, negligence, deception, and other editorial offenses. We know that most editors do outstanding work under difficult, conflict-ridden conditions inherent in their role. We, like all researchers, have been the beneficiaries of excellent, helpful, honest, and fair editing and review many times. Counterexamples rarely come to light for three reasons. First, few authors dare speak out against editors; editors can use their position and status to influence future efforts to publish. Second, the alleged offenses are usually poorly documented, because so much editing occurs behind the scenes. This is why a recent article about editorial bias called for publishing earlier versions of articles in manuscript, together with reviewers’ and editors’ comments.1 Finally, editors have near absolute power and can do what they like, in part because most journal boards do not provide oversight or an appeal process.Ethical Standards for Editing While authors have occasionally suffered at the hands of editors, editors have themselves suffered increasingly at the hands of hired ghost-writers, fronted by academic “authors” paid for their cooperation, notably by the pharmaceutical industry.2 The development of good editorial standards has been driven by revelations of pharmaceutical industry influence, including suppression of negative findings, falsification of data, and control of analysis and conclusions. Commercial influence has become so pervasive that Richard Horton, editor of the Lancet (and a leader in setting standards to defend the integrity of science and its journals), bemoaned, “Journals have devolved into information laundering operations for the pharmaceutical industry.”3 Marcia Angell, past editor of the New England Journal of Medicine, decries the evolution of the pharmaceutical companies from science-based innovators to primarily marketing machines that co-opt any institution that might stand in their way.4[cont'd on site - vl] =====In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.