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Editor claims drug companies have a "parasitic" relationship with jour
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     The relationship between medical journals and the drug industry is "somewhere between symbiotic and parasitic," according to the editor of the Lancet, Richard Horton. But at the moment it has swung too much towards the parasitic, he told the House Commons select committee on health last month in his oral evidence on the role of the industry.

    He outlined some of the financial incentives that could, potentially, influence a commercially run medical journal to publish a paper. Many of the formal research papers in the Lancet are reprinted and bought in bulk by drug companies, which use them for marketing purposes, he explained. The drug companies regularly try to exert pressure on the journal to run a paper by arguing that, if the journal does so, they will buy reprints, which will earn the journal more money, he said.

    He explained that the Lancet regularly gets calls from authors trying to see whether the journal might be interested in a paper. "The conversation might go: 慖t抯 likely the company will want to buy several hundred reprints of this paper,? he said.

    As another example of the parasitic nature of the relationship Dr Horton cited the example of a recently submitted paper on cyclo-oxygenase-2 inhibitors. When the journal raised questions with the authors over the paper, the drug company sponsoring the research called Dr Horton, asking him to "stop being so critical."

    He reported to the committee that the company told him, "If you carry on like this we are going to pull the paper, and that means no income for the journal."

    "That is just one example, and it is not that uncommon," he told the committee.

    He outlined some of the measures that had been introduced across medical journals, including the BMJ, to try to reduce research fraud and to eliminate "ghost writing" of leading editorials. But he said this was based on people being honest.

    "However, people do lie," he said.

    One author had claimed that a review was written by him but had made the mistake of leaving on Microsoft Word抯 "track changes" facility in the document he sent, revealing that in fact everything had been ghost written with the help of the manufacturer of the drug. It carried the telltale note "marketing approval required please." "The paper was rejected," said Mr Horton.

    He also hit out at the way drugs were regulated in Britain and decried as "nonsense" the yellow card system for reporting adverse reactions.

    "That is the worst possible way of doing epidemiology," he said. Instead what was needed was a five year periodic review of each drug at every stage on the market. "It would clear out the dross," he said.

    Also giving evidence were Jenny Hope, medical correspondent at the Daily Mail, and Lois Rogers, medical editor at the Sunday Times. Ms Hope denied that drug companies unduly influenced her decisions about what made a news story.

    "I don抰 feel I am being used, but I feel I am a target," she said. In deciding whether or not she pursued a story she said her decisions were based on whether the public should know about it, whether it was of interest, and whether it would be wrong to keep the information secret, she said.

    Both she and Ms Rogers said they needed to know how the regulatory authority reached its decision in granting a licence to new products. At the moment this information is bound by a confidentiality agreement and is not made public in the United Kingdom. "The regulation process needs to be more transparent," said Ms Rogers.

    The BMJ did not submit written evidence to the committee抯 inquiry so was not invited to give oral evidence.(London Lynn Eaton)