I have a somewhat off the wall theory to offer regarding the recent ghostwriting revelations/allegations from the New York Times:
Okay, in this crazy world of the medicine/Pharma interface, can anything really be off the wall?
Let's go back to the revelations from the recent round of ProPublica investigations of drug payments to docs:
One of the things this drove home, though we had much evidence of it before, is that speakers' bureaus are basically bribe machines to reward high-prescribing physicians; the ability to speak coherently is much less of a qualification.
So what are we to make of the fact that (according to documents obtained by the Times) SmithKline Beecham paid muchos bucks to a medical communications company to ghostwrite a textbook that KOLs Drs. Charles nemeroff and Alan Schatzberg could sign on as authors, and the textbook was supposed to educate family docs about how to treat psychiatric illnesses, but only 10,000 copies were sold (vs. a family doc population in the US of about ten times that much)?
Let's ask-- supposing that that book contained information that SmithKline really wanted family docs to know, and that they judged the textbook a useful format by which to convey that information, what would they have done?
Answer--that's easy. The sales for the textbook would have been 100,000 not 10,000. All copies would have been bought by SmithKline. A SmithKline rep would have personally delivered a copy to each family doc in the US, as a gift from the company. The cost would have been chump change for a big drug firm.
So how do we account for the fact that only 10,000 were sold? How about the notion that SmithKline chose to handle KOLs Nemeroff and Schatzberg just like Dr. Big Prescriber up the road, but on a grander scale, given their presumably huge value to the industry as Shills Extraordinaire? Everyone knows that having a medical textbook to list on your CV as an author is a plum perk for an academic physician. So SmithKline ultimately didn't care if no one bought the book and if no family doc ever read a page of it--just like they really don't care who or how many attend the drug talk given by the paid speaker, so long as the speaker gets his bribe to put in his pocket and know's there's more where that came from if he keeps that prescription mill going. (The Times did not reveal specifically what Drs. Nemeroff and Schatzberg were paid, personally, for their role in putting their names on the cover of this book; but past behavior would cause us to doubt that they would have participated without being offered a nice honorarium--in addition to the honorific of having a major publication to list on their CVs.)
Like I say, maybe I've finally gone off the deep end. This business will do that to you.