[e-drug] Front page pill pushers

["Joao Carapinha" <carapinhaj@therapy.wits.ac.za>]

Colleagues:
 
Pharmaceutical marketing is an important means with which information is
provided to the market. Journalists are a major contributor to this
process and often face the difficult task of needing to convey as
accurately (balanced) as possible the benefits of a new drug. The
article below questions how journalists go about this process. A
possible solution may include basic evidence-based medicine and
pharmacoeconomics training for journalists OR greater use of academic
institutes to support the reporting of drug-related information.
 
Regards
Joao Carapinha
South Africa
www.wits.ac.za/peppro 
Joao Carapinha <carapinhaj@therapy.wits.ac.za>
  
http://bmj.bmjjournals.com/cgi/content/full/331/7513/410?etoc
BMJ  2005;331:410 (13 August), doi:10.1136/bmj.331.7513.410 
[copied as fair use]
	
Front page pill pushers 

How the media are complicit in drug marketing 

The lay media have long come under attack for not adequately
scrutinising the information emerging from Big Pharma about new
prescription drugs, but now they stand accused of helping to publicise
and promote drug company products. In a hardhitting article in the
current issue of the prestigious US periodical the Columbia Journalism
Review, the press is criticised, in its coverage of drug industry
matters, for failing as a public watchdog. "Americans have always been
obsessed with all things health-related," says the article, "but today a
drug can move almost instantaneously from medical research to miracle
cure through news media that too often seem more interested in hype and
hope than in critically appraising new drugs on behalf of the public"
(www.cjr.org/issues/2005/4/lieberman.asp). 

The article's author, Trudy Lieberman, who is health policy editor of US
watchdog organisation Consumers Union, blames various factors. In short,
she says, journalists all too often fail to: 

- find information sources and case studies other than those offered by
drug companies and their public relations people 

- disclose the financial or other interests of those they quote 

- seek out and evaluate research data. 

Other factors exacerbate the situation, she says: there is the
increasingly sophisticated way that drug companies hide aggressive
marketing activities; there is the growth in direct to consumer
advertising leading to conflict between advertising and editorial in
media organisations; and there is the hard to break culture of newsrooms
in which simplistic black and white stories are seen as so much sexier
than reports painted in more realistic shades of grey. Ms Lieberman also
points a finger at the US Food and Drug Administration and its "somewhat
cozy relationship with the companies it regulates," which sees those
reporters asking tough questions being "frozen out." 

Overall, she says, such a mix finds the press caught up in a drug
industry marketing web that leaves the public without a reliable
watchdog. 

Ms Lieberman?whose article analyses coverage of various drugs that have
since been withdrawn, such as rofecoxib (Vioxx)?is writing about the
United States, but the scenario she outlines is recognised all too
clearly by Dr Ike Iheanacho, editor of the UK based Drug and
Therapeutics Bulletin. "These themes of how the drug industry interacts
with the public involving the media are universal and perennial," he
says. 

Dr Iheanacho points to the standard health reporting formula: "There's a
`break-through,' an interview or quotes from somebody who has benefited,
and maybe a quote from the manufacturer. You don't get a sense of
balance, that there might be side effects, or that the drug might not
even be available for a few years." He adds: "It takes time to be truly
critical. Either you have to look at the studies yourself or talk to
someone or several people in detail. Having done all that you may end up
with a very confused picture and that doesn't make easy journalism." 

Indeed, for journalists not content to settle for "easy journalism,"
reporting can be more than just time consuming. Jo Revill, health editor
of the UK Sunday broadsheet the Observer, believes that UK journalists
do at least display a greater scepticism toward the drug industry than
their US counterparts?but you need more than scepticism to cover the
health beat critically and effectively. The big drug companies, she
says, are reluctant to talk to journalists outside of the trade press,
and while invitations to press conferences about drug launches are
forthcoming, "when you want to ask more detailed questions about a drug
it can be really difficult getting information. The PRs won't deal with
these questions and people in-house don't want to deal with you either."

On the other hand, when drug companies are keen to speak to journalists,
they can be incredibly forthcoming?from offering trips abroad to attend
launches to paying "honorariums" to attend evening "think tanks." 

According to Dr Iheanacho, however, there are glimmers of hope for a
better informed public. There are growing demands for clinical trial
information to be made public and patients are exhibiting a new
enthusiasm for asking questions about their health care. In addition,
uncritical reporting often has a fixed lifespan: as in the case of
Vioxx, today's miracle cure can turn out to be tomorrow's disaster. "The
public will become more sceptical," he says. 
  _____  

Naomi Marks, freelance journalist