If it ain’t quite fixed, break it

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Pharma-bashing in the media has certainly become a lot more sophisticated in the couple of years since the Cox-2 class imploded and the papers effectively broke the news that not all prescription drugs are 100% safe for everyone to whom they are marketed.

On May 10, for example, the quality dailies were full of it. Front page of The Wall Street Journal’s Marketplace section featured details of how Johnson & Johnson had lured physicians into writing significantly more scripts for its anti-anemia drug Procrit through a series of discounts and rebates designed to lower the price and “fatten doctors’ margins.” An attractive color chart showed how this practice had helped Procrit sales overtake those of Amgen’s rival drug Aranesp, while page 2 of the section charted the sordid details of the scheme.

But the Journal’s coverage paled into the background compared to the front page of The New York Times that day. The large color photo space was reserved for the image of a young, lonely-looking girl crossing her suburban street, accompanied by the headline: “Psychiatrists, Troubled Children and Drug Industry’s Role.”

After the state of Minnesota passed a law demanding full disclosure of drug company payments to doctors, The Times had wasted little time in climbing through the window and opening the files. While the hook of the story was the side effects suffered by the young girl in the picture—who had been prescribed, off-label, an antipsychotic for an eating disorder—it quickly morphed into a tale about how pharma is manipulating psychiatrists into writing scripts for children.

Figures from Minnesota’s treasure chest showed that psychiatrists who had received $5,000 or more from drug companies between 2000 and 2005 (for taking lectures) had prescribed three times as many atypical antipsychotics to children. As the story continued inside, filling almost an entire page, all the familiar potshots were taken so that by the end, it had covered such bases as conflicts of issue, kickbacks, off-label uses, branded drugs versus generics, risks, side
effects and, of course, the evils of marketing. That’s a lot of bad stuff for your average Times reader to absorb.

The reality is that this kind of media scrutiny, backed by detailed research, is going to happen a lot more as the industry continues on the long, hard road back to trustville. An unfortunate side-product of greater transparency and disclosure is that it will often give the papers enough ammunition to support the stories they are intent on writing. After all, once you get hold of some real numbers, with a bit of contextual massaging you can use them to support pretty much any claim you like, as this industry knows too well. But there’s a long journey ahead and it’s important not to fall off the credibility wagon.

Stories about the positive steps companies are taking are far less likely to appear in the papers. For example, Eli Lilly announced recently that it will begin full disclosure of all medical education funding via a quarterly log—a movement that MM&M’s senior reporter Marc Iskowitz has dubbed “CME glasnost." Pfizer, Wyeth, Novartis and Shire are among a clutch of companies looking to follow suit.

“Why should we be apologetic for doing the right thing and funding education?” said Lilly’s senior grant associate Jason Singer, PharmD. “We’re just going to put it all out there and not be apologetic anymore.”

Now that’s what I call a news story.

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