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 Op-Ed: News Media Being Infiltrated by Doctors Paid to Hawk Drugs for Big Pharma
Every day, journalists report on medical claims made by supposed “experts.” But we shouldn’t take their advice at face value, as more evidence points to how health care news fails to properly inform the public.
Digital Journal — Recently, Katie Couric and CBS Evening News warned viewers about the dangers of Lasik vision correction procedures in a segment chillingly called The Dark Side of Eye Surgery. It included the requisite detractor doctor saying Lasik “is a terrible idea.” Another doctor claims the surgery “produces overwhelming joy and happiness.” The story outlines the risks and problems associated with this surgery, all within two minutes.
But Gary Schwitzer, a professor of journalism at the University of Minnesota, wasn’t happy with the CBS report. As publisher of HealthNewsReview.org, he reviews medical news for balance and accuracy, rating articles on a scorecard to determine if reports conveyed the most thorough info possible. Schwitzer had a few issues with The Dark Side of Eye Surgery:
“It fails to make clear that the Lasik procedure is elective and expensive… It fails to cite facts regarding what may be the most important measure of surgical success/patient satisfaction: The ability to see well without glasses… The segment fails to describe which side effects is permanent, and what proportion are disabling.”
CBS is not alone in this sharp critique. Schwitzer and his team of reviewers have looked at 544 stories from major news outlets between April 2006 and April 2008. To receive a satisfactory score, journalists had to quote an independent expert uninvolved in the research and they had to attempt to report potential conflicts of interest. Schwitzer says half the stories failed to meet these two criteria.
HealthNewsReview was created to help improve the public’s “critical thinking of some of the claims that are made in health care and made in health care journalism,” Schwitzer said in an interview.
There is good reason for a site like Schwitzer’s, especially in an era where media “experts” are suspect of being in the pocket of major corporations.
Too often, medical professionals appear in radio and TV broadcasts to debunk a health care claim, only to be later unmasked as the recipient of corporate handouts. For instance, all four experts on a radio news program combating links between antidepressants and suicide were found to have financial ties to antidepressant manufacturers. Also, the radio show itself had received funding from Eli Lilly, the maker of Prozac.
In other cases, "breaking medical news" reported in scientific journals can sometimes be tailored to promote drugs from companies that have massive sales and PR budgets, according to a book called 'Our Daily Meds'. According to author and New York Times reporter, Melody Petersen, pharmaceutical companies have a two-pronged approach; go after consumers on one front, and doctors on the other.
In a very startling statistic, Petersen says there is one sales rep for every six physicians in the United States. Petersen explained the relevance of this stat in an interview with ABC:
"There's half a million drug-sponsored meetings or parties or dinners for physicians every year," she said. "It's hundreds per day of these parties that the drug industry sponsors for physicians where the physicians are wined and dined. Actually here in the US, often they're also given a nice cheque for $500 just for attending. And then the drug industry will hire another physician to lecture them on why they should be prescribing one of these new drugs."
This is a very big problem, but some States seem to be trying to do something about it, going so far as to suggest a ban on gifts for doctors, saying "pharmaceutical and medical device industries give gifts, meals and other freebies to doctors to influence what they prescribe." Sounds like the industry needs a prescription for objectivity.
Supposedly independent experts are truly just sneaky marketers trying to win over a gullible public. Medical professionals are held in such high regard, and their credentials are so rarely questioned, that it isn’t difficult to hoodwink lazy journalists who fail to dig deep into the expert’s pockets. Every reporter should be wary of a doctor who is so passionate about debunking health claims, it comes off as strangely aggressive.
Every media outlet should be using their built-in bullshit-detector, as Hemingway wrote. When academic department chairs have ties to industry leaders and major drug manufacturers, the eyebrows should be raised. Raised way up. When health care experts appear on 24/7 news stations to promote the latest gastric bypass surgery, viewers should take their announcements with a large bear-hug of salt. For too long medical expertise has blared into our living rooms without question, without argument. Only now, as sites like HealthNewsReviews.org bring the truth to light, does the public see how jaded every news article can be.
Luckily, the medical establishment wants to fight this problem, too. The Canadian Medical Association Journal found researchers who get funding from drug and medical-device manufacturers are up to 3.5 times as likely to proclaim their study drug or medical device works than are researchers without this funding.
And a Yale University School of Medicine study several years ago found that “financial relationships among industry, scientific investigators, and academic institutions are widespread. Conflicts of interest arising from these ties can influence biomedical research in important ways.”
Critically analyzing health care news is one of the most valuable actions we can take as news readers and viewers. More often than not, our bodies — and our bodies of knowledge — depend on it.
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It's also happening in advertising. Perhaps not as big of a surprise but Politico reports:
* Pfizer, which ran more than $250 million worth of ads for its Lipitor anti-cholesterol medication. The ads featured artificial heart pioneer Robert Jarvik, who’s portrayed in the commercial as if he’s giving medical advice, though in fact he’s not licensed to practice medicine.
* Merck/Schering-Plough, which continued a $200 million-per-year advertising campaign for its own anti-cholesterol drugs, Vytorin and Zetia, even as it was alleged to have hidden clinical trial data showing the drug was no more effective than much cheaper generic alternatives. The companies sold $5.2 billion worth of the drugs last year.
* Johnson & Johnson, which is alleged to have marketed its Procrit medication as an energy enhancer, although it was not approved for that use. The drug was produced by a subsidiary, Ortho Biotech Products.
What surprises me most about all this is the fact there is 1 Pharma PR/sales person for every six physicians in the U.S.
That is so terrifying. -
As someone who has worked as a medical writer and editor for many years I can say that I've seen the Pharma creep into the most obscure places of PR, media, advertising, and science research. It is also very common for doctors and researchers to hold competing interests in Pharma companies, for example they may work on a funded clinical trial for Janssen Ortho but then sit on the advisory board of Johnson & Johnson. I truly believe that when a doctor receives any kind of funding or honorarium that they have lost credibility. Especially when they hop from company to company because they are simply chasing a cheque.
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@ Cat Lover
As someone who has worked as a medical writer and editor for many years I can say that I've seen the Pharma creep into the most obscure places of PR, media, advertising, and science research. It is also very common for doctors and researchers to hold competing interests in Pharma companies, for example they may work on a funded clinical trial for Janssen Ortho but then sit on the advisory board of Johnson & Johnson. I truly believe that when a doctor receives any kind of funding or honorarium that they have lost credibility. Especially when they hop from company to company because they are simply chasing a cheque.
If you've worked as a med writer, how do you avoid the same traps and pay-offs? Has Big Pharma ever courted you to write about them favourably or with a particular slant? -
It is important to point out that in Canada medical information aimed at consumers is reviewed by an impartial board, sometimes more than one depending on the nature of the product.
When writing for Pharma, you are instructed to write as favourably about the product as possible. I have seen instances where the worst side effects of one drug were deliberately omitted while those of comparable products were highlighted. It is rare to see this get past an impartial review but it does happen.
The difference is that I don't go out into the public and promote a product with my name and reputation behind it. I choose to write to governing guidelines, which are intended to remove product bias. What the Pharma does when I am finished is another story.
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@ Cat Lover
It is important to point out that in Canada medical information aimed at consumers is reviewed by an impartial board, sometimes more than one depending on the nature of the product.
When writing for Pharma, you are instructed to write as favourably about the product as possible. I have seen instances where the worst side effects of one drug were deliberately omitted while those of comparable products were highlighted. It is rare to see this get past an impartial review but it does happen.
The difference is that I don't go out into the public and promote a product with my name and reputation behind it. I choose to write to governing guidelines, which are intended to remove product bias. What the Pharma does when I am finished is another story.
Wow. So how do you keep your interest or trust in medical journals? I'm sure you don't trust a press release or advertisement but do you still have faith in the medical community given all the concerns raised in this article? -
We all need some sort of pharmaceutical product at one time or another. There are advantages and disadvantages for each drug on the market, but in the end drug x is usually virtually the same as drug y. Ultimately, you have to decide if the benefits outweigh the risks and don't be afraid to ask your doctor or pharmacist questions - lots of questions.
My trust and faith in medical journals is a different story entirely. The peer-review process is broken and needs to be seriously overhauled.
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This is a subject that has begun to give me pause recently, I get a considerable number of medical related press releases each day and try to sort through any that grab my attention to see who is who.
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@ Cat Lover
My trust and faith in medical journals is a different story entirely. The peer-review process is broken and needs to be seriously overhauled.
What makes you say that? -
@ Bob Ewing
This is a subject that has begun to give me pause recently, I get a considerable number of medical related press releases each day and try to sort through any that grab my attention to see who is who.
Press releases from pharmaceutical companies can be dangerous. I remember the courses in university on this topic specifically; they throw in a lot of numbers but not who funded the studies. It's a journalist's responsibility to look into it, and if they report the numbers they need to make it clear it came from a press release. -
but not who funded the studies That is the key point -
@ Chris Hogg
What makes you say that?
A research paper may be submitted to a particular journal and the paper may then be reviewed by a number of board or advisory members who hold membership with that journal. Four things could happen: they accept the submission without review, they review and then accept the submission, they ask the author to review certain aspects of the submission or rewrite, or they may reject it entirely. The reviewers look at quality of data, soundness of experimental design, and logic of the method and assumptions made.
These reviewers aren't able to follow the research into the clinic or laboratory, they go based on what the author says. We all know that bad science gets published but we really don't know how often. Just because a doctor or researcher has an education doesn't mean that they are infallible when it comes to reading these lengthy, detailed submissions.
To put this in perspective, for example, the Canadian Medical Association Journal (CMAJ) is published biweekly and rejects approximately 88% of "unsolicited" research and review manuscripts received. Their policy concerns me because there is a definite implication that they are soliciting manuscripts, whereas I think it should be the other way around. I don't see why a journal should be soliciting research; I think research should come to them. They probably aren't soliciting it from everyone either; I get the impression from experience that they tend to look for articles or topics from friends and colleagues and that has the potential to introduce bias. -
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@ Brant David McLaughlin
I am vastly more afraid of CBS and their ilk than I will ever be of "Big Pharma".
You're drifting away from the main issue: Ethics for big Pharma. So it's important to stay focused on the topic of this story. Please restrain from empty slogans in favor of tackling specific problems addressed in this important article dealing with drug makers’ sales practices. -
I personally feel that drug commercials should be banned on TV and in magazines......what is the real purpose anyway? If your doctor is any good, he or she will know what medication(s) to suggest in the event of an illness. Too many people are brainwashed into believing that the desire to move their legs around at bedtime or the clouding of their big toenail requires meds, and go running off to a physician in search of the most recently advertised pill that is supposed to cure whatever is ailing them. Combine that with doctors on 'the take' and you have a very serious situation.
Great article David!
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This so hits home for me on so many levels.
Working in the industry, those with the biggest bank accounts get the studies and get the drug approvals, bottom line.
Drug rep sponsored dinners and events was all too common - I went to several with a physician I dated and despite the stoicism of the crowd (they were psychiatrists....ack), the freebies, kickbacks and cuisine were all part of the "specific drug" sponsored event. Topic? Electroshock Therapy! Interesting.
Lasik - had it not been for a wal mart optometrist who doesn't get kick backs from the industry and charges just $49 for exam, I might have been swayed to have the elective procedure. With my level of astigmatism, I cannot and IF I do, the procedure could cause irreversible and non-correctible with specs results. Not good for me! I didn't hear that on any commercial.
I'm with pam about the advertising on tv. A 2-min tv segment geared to promote a drug, backed by men in white coats? Just look at the lipitor case with the Jarvik heart guy who is really a scientist (misleading?). Last 10 seconds overwhelm with side effects, including nasuea, diahrea, vomiting, heart attack and death. Lovely.
I was recently prescribed TWO non-generic meds, one with no reason. Kickbacks? you bet.
Always question your DR (I'm learning, sadly) and always research the written effects on the insert and studies done on the drug itself and that for which it is indicated.
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Here in India, the big Pharma majors 'pay' doctors indirectly for 'promoting' / pushing their drugs in the prescriptions. And some of the medicines are really the expensive variants. Cheaper and no less effective options are available. The direct result of such blatant promotion is often a world trip for the doctors on the company's expenses.
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I agree that Big Pharma people are not saints. What they do is often beyond unacceptable. But do they have any choice? They are competing with a bunch of crooks that is taking in billions of dollars every year for producing nothing at all.
The health industry needs to be cleaned up. Unfair competition must be banned. A new drug that works costs billions of dollars in development and tests. A homeopathic "medicine" costs nothing and is approved right away. For good reason: it contains nothing and it does nothing. It is as safe as pure water. Horribly expensive pure water. The profit margin is close to 100%. No pharmaceutical company, regardless of size can ever compete against such odds and win. So, they resort to dishonest practices. It is not good, it is not defensible. It is, however, understandable.
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These reviewers aren't able to follow the research into the clinic or laboratory, they go based on what the author says. We all know that bad science gets published but we really don't know how often. Just because a doctor or researcher has an education doesn't mean that they are infallible when it comes to reading these lengthy, detailed submissions. Rejecting journals because bad stuff gets published is missing the point entirely.
Journals do not publish established science, they publish tentative science that is considered to have merit based on what the authors and peer-reviewers think.
It is by publishing their research into reputable journals that researchers present their work to the scientific community, that they open it up for criticism, for attempts to duplicate it, in short, the journals are a very important part of the system that makes science advance. -
On Business Week today, they have a cover story on this very topic. DJ was first, if I may point out :)
A group of researchers at Duke University scoured more than 700 studies on heart stents published in medical journals over the course of a year, and were shocked to discover two huge omissions. First, 83% of the papers failed to disclose whether the authors were paid consultants for the companies that made the products they wrote about.
Perhaps more surprising, 72% of articles describing clinical trials and other research-related matters didn't identify who funded the research. The Duke paper, published May 7 in the online journal PLoS One, raises fresh questions about the ever-growing financial ties between doctors and companies, and the adequacy with which those relationships are communicated to the public.
Absolutely crazy if you ask me. This is a big red flag for the industry and if it doesn't want to make itself irrelevant it better recognize its own symptoms and prescribe something for its ailment.
Bad doctor joke. Sorry. -
@ Bart B. Van Bockstaele
Rejecting journals because bad stuff gets published is missing the point entirely.
Journals do not publish established science, they publish tentative science that is considered to have merit based on what the authors and peer-reviewers think.
It is by publishing their research into reputable journals that researchers present their work to the scientific community, that they open it up for criticism, for attempts to duplicate it, in short, the journals are a very important part of the system that makes science advance.
That is true, but I also believe the opposite is true. Peer-reviewed journals are only supposed to publish science that is reviewed and filtered. That apparently doesn't always happen.
As my comment above illustrates, there are a number of problems or "journalistic" questions that don't get asked. Reputation plays a huge role that kills objectivity as well; Dr. X will not likely tell his friend Dr. Y that his whole study on Drug A is a pile of fluff. It would screw up their relationship and ultimately make that 9 a.m. tee-off time awkward.
Joking aside, the checks and balances are there, but I don't think they are always used based on the evidence we've been presented. -
@ Chris Hogg
That is true, but I also believe the opposite is true. Peer-reviewed journals are only supposed to publish science that is reviewed and filtered. That apparently doesn't always happen. Indeed. That is why the reputable journals are so expensive, they do a lot of verifying before someone gets published. You may remember the case on homeopathy with Jacques Benveniste's article in Nature. John Maddox took magician James Randi with him to have a look at the laboratory himself. Benveniste was totally ridiculed as a result. That is the beauty of the scientific process. While individual scientists may or may not be entirely honest, the system will ensure that the truth will surface, sooner or later. Compare that with what alternological competitors are doing.
We can also remember the South Korean cloning scandal. Colleague researchers brought it out.
Fraud is everywhere and is of all times. Who doesn't remember the fraud of Mendel, the father of modern genetics? The fraud of Piltdown Man that implicated scientific near-Saint Teilhard de Chardin? And so many many more.
The point is that it all comes out eventually, because scientists who base their own research on fake results will not obtain the results they expect. Only publication in journals makes that possible. -
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