The Medical Journals’ Sell-Out—Getting Paid to Play

Author: The Children's Health Defense Team

[Note: This is Part IX in a series of articles adapted from the second Children’s Health Defense eBook: Conflicts of Interest Undermine Children’s Health. The first eBook, The Sickest Generation: The Facts Behind the Children’s Health Crisis and Why It Needs to End, described how children’s health began to worsen dramatically in the late 1980s following fateful changes in the childhood vaccine schedule.]

The vaccine industry and its government and scientific partners routinely block meaningful science and fabricate misleading studies about vaccines. They could not do so, however, without having enticed medical journals into a mutually beneficial bargain. Pharmaceutical companies supply journals with needed income, and in return, journals play a key role in suppressing studies that raise critical questions about vaccine risks—which would endanger profits.

An exclusive and dependent relationship

Advertising is one of the most obviously beneficial ways that medical journals’ “exclusive and dependent relationship” with the pharmaceutical industry plays out. According to a 2006 analysis in PLOS Medicine, drugs and medical devices are the only products for which medical journals accept advertisements. Studies show that journal advertising generates “the highest return on investment of all promotional strategies employed by pharmaceutical companies.” The pharmaceutical industry puts a particularly “high value on advertising its products in print journals” because journals reach doctors—the “gatekeeper between drug companies and patients.” Almost nine in ten drug advertising dollars are directed at physicians.

In the U.S. in 2012, drug companies spent $24 billion marketing to physicians, with only $3 billion spent on direct-to-consumer advertising. By 2015, however, consumer-targeted advertising had jumped to $5.2 billion, a 60% increase that has reaped bountiful rewards. In 2015, Pfizer’s Prevnar-13 vaccine was the nation’s eighth most heavily advertised drug; after the launch of the intensive advertising campaign, Prevnar “awareness” increased by over 1,500% in eight months, and “44% of targeted consumers were talking to their physicians about getting vaccinated specifically with Prevnar.” Slick ad campaigns have also helped boost uptake of “unpopular” vaccines like Gardasil.

Advertising is such an established part of journals’ modus operandi that high-end journals such as The New England Journal of Medicine (NEJM) boldly invite medical marketers to “make NEJM the cornerstone of their advertising programs,” promising “no greater assurance that your ad will be seen, read, and acted upon.” In addition, medical journals benefit from pharmaceutical companies’ bulk purchases of thousands of journal reprints and industry’s sponsorship of journal subscriptions and journal supplements.

In 2003, an editor at The BMJ wrote about the numerous ways in which drug company advertising can bias medical journals (and the practice of medicine)—all of which still hold true today. For example:
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• Advertising monies enable prestigious journals to get thousands of copies into doctors’ hands for free, which “almost certainly” goes on to affect prescribing.
• Journals are willing to accept even the most highly misleading advertisements. The FDA has flagged numerous instances of advertising violations, including ads that overstated a drug’s effectiveness or minimized its risks.
• Journals will guarantee favorable editorial mentions of a product in order to earn a company’s advertising dollars.
• Journals can earn substantial fees for publishing supplements even when they are written by “paid industry hacks”—and the more favorable the supplement content is to the company that is funding it, the bigger the profit for the journal.

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Discussing clinical trials, the BMJ editor added: “Major trials are very good for journals in that doctors around the world want to see them and so are more likely to subscribe to journals that publish them. Such trials also create lots of publicity, and journals like publicity. Finally, companies purchase large numbers of reprints of these trials…and the profit margin to the publisher is huge. These reprints are then used to market the drugs to doctors, and the journal’s name on the reprint is a vital part of that sell.”

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