“By accepting only advertisements for drugs and medical devices, medical journals have accepted an exclusive and dependent relationship with pharmaceutical companies,” said a team of Georgetown researchers in a paper to be published in the Public Library of Science (PLoS) Medicine on May 2, 2006.
Adriane Fugh-Berman, MD, and colleagues examined advertising in nine multi-specialty medical journals, chosen because they receive the most advertising revenue.
Eight of the nine journals studied by the Georgetown researchers contained advertisements that were almost exclusively for drugs (PLoS Medicine, one of the publications studied, bans drug advertisements). A detailed analysis of representative issues of JAMA, for example, found that 99 percent of 2004’s advertisements were for pharmaceuticals.
“Why not run ads for cars, computers, vacations, or other consumer products that doctors would buy for themselves?” asked Fugh-Berman. “Advertising rates in medical journals are lower than for consumer magazines and reach a targeted audience.” She also pointed out that pharmaceutical ads in journals are third-party advertisements—a doctor whose prescribing is swayed by a drug ad isn’t paying for the product advertised.
Drug companies place a high value on advertising in medical journals, said Fugh-Berman and colleagues, because research has shown that such advertising increases prescriptions for targeted drugs in a dose-related manner. Drug companies get a huge return on investment from these advertisements— the paper cites one study that found that the average revenue increase is 5:1 for every dollar spent on drug ads, in any given month studied.
And medical journals actively solicit business from drug companies, say the Georgetown researchers, who reviewed both advertising policies and materials meant to entice advertisers. For example, the advertising rate card for the Annals of Internal Medicine states that the journal’s audience “constitutes the ideal market for advertisers like you wishing to reach high-prescribing clinicians treating adult patients.” An advertisement in publications aimed at drug companies states, “Place your ad in the New England Journal of Medicine and make our relationship with the medical community yours.”
The scholarly nature of journals confers credibility on both articles and advertisements within their pages, said Fugh-Berman and colleagues Karen Alladin, MS, and Jarva Chow, MS, both graduates of Georgetown’s Complementary and Alternative Medicine Master’s Program.
The authors said that the time has come for medical journals to eschew drug advertisements altogether and find sources of revenue that are less compromising.
“It is imperative that peer-reviewed journals disseminate findings that are unequivocally free from industry's competing agendas. Acknowledging that the acceptance of any money from industry introduces a potential conflict of interest is the first step towards minimizing its influence,” said Chow.
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