June 17, 2002

SHADY DEAL

THE NEW ENGLAND JOURNAL OF MEDICINE STOOPS LOWER

By Nicholas Regush

This was not good news. But not terribly surprising. The famous and over-rated New England Journal of Medicine (NEJM) was announcing that it would now allow doctors with money ties to drug companies to review the products those companies sell.

These "review" articles can greatly boost a company’s profits. Some terribly confused person at the NEJM thinks that the reviewer should receive no more than $10,000 annually from the company whose products s/he is reviewing. Makes a lot of sense, doesn’t it? Does someone have the inside track on how much money will create undue influence? How about $9, 900, or $12,226? Are we being actually asked to believe that the sum of $10,000 will not prevent a reviewer from slanting the review? I can imagine the reviewer thinking, "hell, they didn’t pay me enough, so I’m still going to write off their new drug as crap."

The confused person at the NEJM may actually be its editor, Dr. Jeffrey Drazen, not known to be shy in developing good relations with the drug industry. Drazen says that without the new policy, the journal will not be able to attract good reviewers. There are not enough of them around.

No, there are not enough of them around on Mars or Pluto, but on planet Earth, there are some good ones to be had who don’t even take money from drug companies. Former NEJM editor Jerome Kassirer had no difficulty in finding people. Imagine that. My guess is he didn’t look for them with a telescope.

Drazen is big trouble. His leadership at the NEJM comes at a time when medicine is fighting a blizzard of criticism about corruption, particularly its incestuous ties with drug companies. This new policy only gives the profession another black eye.

This gaff certainly won’t help the NEJM, a journal that has been steadily in decline in the past decade, facing one controversy after another - including the inability to adequately monitor the conflicts of interest of some of its contributors.

The journal bigwigs should fire Drazen and try to find someone who actually understands the grand stupidity of the new policy. Otherwise, the NEJM will be best for puppy poop, rather than for informing doctors intelligently about the value of new drugs.