We thank Dr Vallance1 for his interest in our recent review. To begin with, it is of the utmost importance to point out that Dr Vallance did not actually voice any objections or doubts concerning the scientific facts and the information given in our comprehensive review comparing the aspects of ranibizumab and bevacizumab in relation to their molecular characteristics, in vitro and in vivo properties, and preclinical safety data.2

The issue in question here is Dr Vallance objection to the fact that a medical writer funded by Novartis helped with the preparation of the manuscript. Dr Vallance even goes so far as to insinuate that the authors did not write the article at all. He bases his speculations on the fact that the company Mr Cunningham (the medical writer) works for also supplies ‘complete medical communication services for all marketing needs’. With his reference to an article in ‘The Guardian’3 Dr Vallance finally draws comparison between the review article and ghostwriting commissioned by Wyeth, resulting in scientific articles of questionable content.

To us these allegations and insinuations are libellous.

First, we have written our review in accordance with the guidelines of the International Committee of Medical Journal Editors (ICMJE). The Committee defines the criteria for authorship as follows:

Authors should have participated sufficiently in the work to take public responsibility for relevant portions of the content and should meet all three conditions below: Substantial contribution to conception and design, acquisition of data, or analysis and interpretation of data; and drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.4

Second, professional medical writers are not ghostwriters. The Association of American Medical Colleges states: ‘Transparent writing collaboration with contribution between academic and industry investigators, medical writers and/or technical experts is not ghostwriting. It is recommended that particular care is taken to ensure appropriate acknowledgment of the contribution made by medical writers and to describe their funding. If such assistance was available, the authors should disclose the identity of the individuals who provided this assistance and the entity that supported it in the publishing article. Companies funding the work of medical writers should ensure that writers follow good publication practice’.4

Finally, the guidelines to the publication policies of Nature Journals including Eye require a statement of responsibility in the manuscript that specifies the contribution of each author ( According to the journal an exemplary definition of abuse of financial interest are academic authors who have been paid by pharmaceutical companies to put their names and credibility to reviews produced by ghostwriters employed to boost company products. On the other hand, the journal explicitly states that the financial interests do not invalidate research studies or review articles at all. Authors should identify individuals who provided writing or other assistance and disclose the funding source for this assistance.5

In our review article we clearly state the name of the medical writer, name his company as well as the funding company. We further precisely detailed to which degree the medical writer was involved in the preparation and submission of the manuscript and took full responsibility for the information given in our review, as well as all procedures connected with the preparation and submission of the article. Finally, we would like to emphatically stress the fact that we did not receive any honoraria for the publication of this work.