Texan lawsuits against the manufacturer of the so-called 'phen-fen' diet drugs Redux and Pondimin, Wyeth Ayerst, have revealed yet another problem for the biomedical research community borne of conflict of interest issues.

The Dallas Morning News has reported that Wyeth paid Excerpta Medica—a medical publisher owned by Reed Elsevier, which also carries out contract writing—to 'ghostwrite' articles at a cost of $20,000 each on the health problems associated with obesity. The pieces were then 'authored' by leading scientists, some of whom accepted honoraria in the range of $1,000–$1,500 according to the newspaper. Two of the articles were published subsequently in peer-reviewed, Excerpta Medica journals.

Wyeth voluntarily withdrew the drugs from the market on September 15th, 1997, based on reports that they caused heart valve abnormalities. Although the purpose of the lawsuit is to establish what Wyeth knew and when, and given that contract writing is standard practice within the pharmaceutical industry, the case has highlighted the need for scientific journals to adopt clear disclosure policies, to enforce them, and for researchers to adhere to them.

One of the review papers (Am. J. Med. 100(2), 230; 1996) was authored by Albert Stunkard, University of Pennsylvania. The journal has a clear disclosure policy that includes the statement, "Because reviews and editorials are based on selection and interpretation of the literature, the Journal expects that authors of such articles will not have any financial interest in a company (or its competitor) that makes a product discussed in the article." The statement continues, "Information about potential conflict of interest will be...published with the manuscript at the discretion of the editors."

Stunkard devotes paragraphs to the weight-reducing effects of d-fenfluramine, but no disclosure statement is made. According to the Dallas newspaper, Stunkard claims "Excerpta did not tell him that the honorarium came from Wyeth." Stunkard did not respond to requests from Nature Medicine to discuss the issue.

The other review article (Clin. Ther. 18(6), 1006; 1996) by F. Xavier Pi-Sunyer, St Luke's Hospital Center, New York, was accompanied by an editorial that referred to the risk of pulmonary hypertension caused by dexfenfluramine as "small (28 cases per million person years)." Again, the journal in question states, "Upon submission authors will be required to disclose, in writing, any financial interests (e.g employment, consultancies, stock ownership, honoraria, expert testimony)..." but adds, "...This information, in whole or in part, may be published at the discretion of the Editor-in Chief after consultation with the author..."

Publisher Stan Heimberger, explained that "only if, in the opinion of the Editor-in-Chief or the Editors, disclosure has a impact, would the journal feel the need to add this in the text itself." Pi-Sunyer told Nature Medicine that he did not accept the honorarium, and therefore no disclosure appeared in the article.