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September 17, 1997

Bioequivalence of Levothyroxine Preparations: Issues of Science, Publication, and Advertising

JAMA. 1997;278(11):897. doi:10.1001/jama.1997.03550110035024

To the Editor.  —The article by Dr Dong and collegues,1 along with the accompanying letters and Editorial,2 was a superb presentation regarding the controversy over the bioequivalence of levothyroxine preparations and the issues that arise when commercially supported research produces results that are at odds with the financial interests of corporate sponsors.However, it was surprising to see 2 advertisements for Levoxyl-brand levothyroxine (formerly named Levoxine), manufactured by Jones Medical Industries Inc, 1 of the 4 thyroid preparations studied in the article by Dong et al that claims "any of the 4 preparations studied can be effectively used for levothyroxine replacement therapy." The advertisements tout the cost savings between their product, Levoxyl, and Synthroid and contain an unusual note of the company's stock symbol. The second advertisement is seemingly strategically placed only 4 pages after the Editorial.It would be difficult to ascribe the sudden appearance of these ads, especially from