Tag Archives: pharmaceutical industry

Prescribing data and the side effects of assumptions #ahcj14

Jaclyn Cosgrove

About Jaclyn Cosgrove

Jaclyn Cosgrove is a medical and health reporter at The Oklahoman. She is attending Health Journalism 2014 on an AHCJ Rural Health Journalism fellowship, which is supported by The Leona M. and Harry B. Helmsley Charitable Trust.

Reporters curious about the financial relationship between physicians and pharmaceutical companies can use publicly available data as a starting point – although that comes with some caveats, journalists and industry leaders say.

During the workshop “Covering prescription drug data,” Charles Ornstein, ProPublica senior reporter, pointed out resources that ProPublica has created that reporters can use to write stories about doctors in their communities. Continue reading

Reporter focuses on chronic pain for series on opioid use

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Lisa Bernard-Kuhn

Lisa Bernard-Kuhn

When The Cincinnati Enquirer set out to look at the societal costs of the deadly opioid crisis, reporter Lisa Bernard-Kuhn was assigned to look at the role of chronic pain.

During more than eight months of reporting, she looked into how doctors measure pain, how effect opioids are at treating pain, patients’ expectations and more.

In an article for AHCJ, she explains how she was able to get doctors and patients to talk on the record and shares some of her most useful sources and lessons learned.

Reporter looks at why, how clinic banned drug reps and their samples

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Markian Hawryluk

Markian Hawryluk

Six years ago, a clinic in Oregon made the decision to ban representatives from the pharmaceutical companies. The doctors and staff say goodbye to free samples of expensive drugs, lavish lunches, pens, notebooks, mugs, toys for children and other “benefits.”

Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin, picked up on a recent journal article about the transformation and used that as his inspiration to write about how the clinic made its decision and how it changed the way doctors there practice medicine, as well as how the move impacted the community.

As data is collected under the Physician Payments Sunshine Act, a part of the Affordable Care Act that will require pharmaceutical companies to disclose the money and gifts given to physicians, reporters may start noting similar changes in their area.

Read more about how Hawryluk reported the story and what he learned about the influence drug reps and samples have on prescribing.

Pharmaceutical industry influence starts with the doctor’s prescribing pen #ahcj13

Tracey Drury

About Tracey Drury

Tracey Drury is a reporter at Buffalo Business First. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Can a doctor’s prescription be bought for a tuna sandwich?

Whether it’s a tuna sandwich, steak dinner or a four-figure payment, there’s always the possibility of influence. And that’s how conflicts of interest begin in the medical field.

That was the message this morning from reporters Peter Whoriskey of The Washington Post and John Fauber of the Milwaukee Journal Sentinel during their panel on reporting on medical and financial conflicts of interest during AHCJ’s Health Journalism 2013 in Boston.

“Their job is to sell as much product as they can and maximize profits,” Fauber said of the pharmaceutical companies. “One of the ways they do that is by creating financial relationships with various stakeholders, which can be doctors, medical societies or medical schools. While this may be good for the bottom line of the drug companies, it may not work out for the patients.”

Fauber advised journalists to be on the watch for several things: promotional speaking gigs by physicians; participation in continuing medical education (CME) events; financial relationships between medical journal editors and drug companies; and royalties that come back to hospitals and physicians.

“It struck me very quickly that all the cynicism the media brings to politicians or companies, anybody, is held in abeyance for doctors and anybody that wants to heal you,” Fauber said. Continue reading

Even in treatment guidelines, pharma conflicts abound

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

As part of the ongoing Milwaukee Journal Sentinel and MedPage Today series “Side Effects” John Fauber and Ellen Gabler “examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the United States” and unearthed yet another tactic by which “pharmaceutical companies, with billions in sales at stake, exert a powerful but often unrecognized influence over the practice of American medicine.”

Issued by leading medical associations and government institutions, treatment guidelines are supposed to be based on rigorous science. But the committees that write them have been dominated by doctors who have worked as paid speakers, consultants or advisers for companies selling the recommended drugs.

In their investigation, the duo found:

  • Nine guidelines were written by panels where more than 80 percent of doctors had financial ties to drug companies.
  • Four panels did not require members to disclose any conflicts of interest. Of the 16 that did, 66 percent of doctors on the panels had ties to drug companies.
  • Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing. Medical experts have raised such questions about guidelines for anemia, chronic pain and asthma.

For extensive anecdotes and examples, dig into the full piece.

Ruling has potential to impact patient care, advertising

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

The Milwaukee Journal Sentinel‘s John Fauber explains what a federal appeals court ruling this week might mean for patient care, television advertising and many other issues.

The case of United States vs. Alfred Caronia, a pharmaceutical company representative, “involved the right of commercial free speech, applying it to the complicated world of pharmaceutical industry promotion of prescription drugs.”

Caronia was prosecuted for making off-label promotional statements about Xyrem, a drug approved in 2002 to treat narcolepsy patients. He contended his statements were protected by the First Amendment, saying that the government couldn’t “prohibit or criminalize a drug company’s truthful, non-misleading off-label promotion to doctors.”

Fauber notes that “The appeals court essentially agreed, noting that Caronia never conspired to put false or deficient labeling on the drug.”

In his article, Fauber – no stranger to covering conflicts of interest in the medical industry – outlines the surprisingly far-reaching potential effect of the ruling – called a “watershed moment” by one source.

Post-election: What aspects of health reform are reporters focused on?

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

In addition to AHCJ health reform topic leader Joanne Kenen’s predictions for health reform after the election, we’re reading other stories and timelines that show where implementation (you’re going to hear that word A LOT) is going.

PricewaterhouseCoopers LLP offers its perspective on what effect the election will have on American health care. Its timeline focuses on “stakeholders,” such as insurers, health care providers, employers, the pharmaceutical and life sciences industries and, yes, consumers. It concludes that the health sector must fundamentally transform the way it operates and offer real value.

Kaiser Health News’ Jay Hancock talked to health policy analysts about what to expect for health reform, with responses that range from expecting the Republican-controlled House to delay implementation by withholding funding to “It’s full-steam ahead with implementation.” Hancock’s story points out the looming deadline to launch health insurance exchanges, the subject of a recent AHCJ webcast that is worth re-visiting now.

Matthew Herper, of Forbes, takes a different tack with his “Note to The Pharmaceutical Industry Upon The Re-Election Of Barack Obama,”in which he tells the industry that it has no friends in politics now and the future lies in innovation. He lays out some visions for the future.

The Henry J. Kaiser Family Foundation has an interactive timeline to show key dates and provisions in the implementation of the ACA.

On a somewhat lighter – but still useful – note, Kenen pointed out that as health reform moves forward, those of us who write about it need an arsenal of synonyms for “implementation.” See what she and some other top health journalists came up with.

AHCJ webcast
Thursday, Nov. 8, at 1 p.m. ET.

On Thursday, an AHCJ webcast will look at “What does the election mean for senior health?” with an eye to explaining the outcome for seniors on Medicare, older adults who receive long-term care services from Medicaid and other programs that serve our elderly population. The blue-ribbon panel includes moderator Judith Graham, health care journalist and AHCJ topic leader on aging, Joseph Antos of the American Enterprise Institute, Karen Davis of The Commonwealth Fund, and John Rother of the National Coalition on Health Care.

Finally, remember that Kenen and other journalists have been compiling key resources to help cover all aspects of health reform for more than a year in AHCJ’s Core Topic pages on health reform.

We’ll continue to pick out good stories that should help move the story forward and give reporters more story ideas – so check back with Covering Health often. And, if you’ve seen stories you think are helpful, please include links in the comments below.

OxyContin’s early poster children: Where are they now?

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

More than a decade into America’s new age of opiates, the long-term effects of the ubiquitous prescription painkillers are starting to be felt on a real, measurable scale. As part of an evolving investigation for the Milwaukee Journal Sentinel and MedPage Today, John Fauber and Ellen Gabler drive this home by following up on seven patients – and one physician – featured in an early promotional video for OxyContin maker Purdue Pharma.

Originally conceived as a teaching aid, the video was ultimately used in a marketing campaign in which Purdue sent it to about 15,000 doctors. A Purdue subsidiary has since paid $634 million in penalties for misbranding OxyContin in its various promotional campaigns but, as the reporters found, the patients who used the drug sometimes paid an even steeper price, as demonstrated by the subsequent lives of the seven “poster children” featured in that video. I’ll let Fauber and Gabler take it from here.

The subjects who spoke glowingly of their experiences with OxyContin in the video 14 years ago offer a case history of sorts.

Two of the seven patients were active opioid abusers when they died. A third became addicted, suffered greatly, and quit after realizing she was headed for an overdose. Three patients still say the drug helped them cope with their pain and improved their quality of life. A seventh patient declined to answer questions.

The doctor who enlisted his patients for the video and played a starring role, now says some of the statements went too far.

Within this broad sketch, the reporters find much room for story and nuance, touching upon everything from the impact of the drug on patients with a history of addiction to the legitimate success stories of patients who had their lives changed by the powerful narcotic. It’s a well-drawn, big-picture portrait of the swath opiates have cut through modern American, told through the lens of a unique and fascinating narrative device.

Faced with shortages, paramedics turn to expired drugs

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Reporting on how drug shortages are impacting paramedics, The Associated Press’ Jonathan Cooper discovered things had deteriorated to the point that, he writes, “Paramedics reported asking some of those facing medical emergencies: ‘Is it OK if we use this expired drug?’

Based in Oregon, Cooper found that, in fact, paramedics around the northwest have been forced to dig up supplies of expired drugs to meet critical needs. He writes that, while manufacturers don’t seem to be willing to discuss drug effectiveness beyond declared lifespans, “Medications are only guaranteed to work as intended until their expiration date. When stored properly, most expired drugs won’t be harmful to patients but will become less effective with time, according to medical professionals.”

State public health officials, who license ambulances and in some cases dictate the medications they must carry, are loosening their rules to help emergency responders deal with the various shortages. Oregon health officials last week began allowing ambulances to carry expired drugs, and southern Nevada has extended the expiration dates for drugs in short supply. Arizona has stopped penalizing ambulance crews for running out of mandated medications.

Some agencies have reported keeping their drug kits fully stocked by substituting alternative medications, some of which have additional side effects or higher costs, or by diluting higher dosages to get the less-concentrated dose needed.

Past shortages have included key painkillers and sedatives. Current critical needs include epinephrine and morphine – and you don’t have to be a pharmacist to imagine why a shortage of those might be problematic for front-line medics.

Manufacturing quality lapses, production shutdowns for contamination and other serious problems are behind many of the shortages, according to manufacturers and the FDA. Other reasons include increased demand for some drugs, companies ending production of some drugs with small profit margins, consolidation in the generic drug industry and limited supplies of some ingredients.

Pfizer’s online community about aging fails to impress blogger

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), a Colorado-based freelancer, is AHCJ’s topic leader on aging, and as such curates related material at healthjournalism.org. She welcomes questions and suggestions on aging issue resources and tip sheets at judith@healthjournalism.org.

If you don’t know about Ronni Bennett’s blog – Time Goes By: what it’s really like to get older – you should.

Core Topics
Health Reform
Aging
Other Topics

It’s one of the most consumer-centered sources of information about aging on the Internet. For the most part, it’s written by people experiencing this stage of life firsthand, not those studying or writing about it from a distance.

Bennett was a longtime journalist before she ran into what she calls “a wall of age discrimination” and ended up forcibly retired. The blog expresses her values: Drop the pretense, tell it like it is, and steer clear of advertising and sales pitches.

Bennett describes the site’s genesis this way:

“It was launched in 2003 after I had spent seven or eight years on a personal research project to find out what it’s like to grow old. There wasn’t much good news. From the popular press to scholarly and medical journals, books, government, advocacy groups and NGOs, one message stood out: aging equals decline, disease and debility. No one had anything good to say about it.

Refusing to believe that my future would be that sad and bleak, and since no one else was was doing it, I decided to write about what it’s really like to get old. I had no illusions then that there would be much audience for such a loser topic but in time, I was happily proved wrong.”

If you spend time on the blog, you’ll find an abundance of riches. In addition to regular posts from Bennett and other contributors, there is a carefully compiled list of blogs by and about elders – a gold mine for reporters. There is Bennett’s touching description of her mom’s final illness and death, a subject that all kinds of writers have been tackling recently in various publications. (More on this later in another blog post)

And there is a weblog, the Elder Storytelling Place, where people can share their day-to-day experiences with humor, tenderness, practicality, or any other approach that seems fitting. I especially like the way Bennett introduces this section:

“Among Carl Jung’s seven tasks of aging is to find meaning in one’s life and one way to help in this task is to pull together, piece by piece, one’s memories – great and small – into a coherent storyline. In doing so, there is a natural shift of our attention inward, says Jung, leading to the removal of regret and to reconciliation. In telling our stories we not only fulfill Jung’s task for ourselves, we pass on the wisdom we have gained to those who listen or read.”

I thought of Time Goes By this week when I encountered the media buzz accompanying a new initiative called “Get Old,” funded by drug giant Pfizer and supported by advocacy organizations such as the National Alliance for Caregiving and Easter Seals.

(See the press release here. For selected media coverage, see the Washington Post‘s write-up and CBS Money Watch’s and USA Today‘s.)

The centerpiece of this project is a new website, www.GetOld.com. In press release speak, the site is touted as a “first-of-its-kind online community” where “people can get and share information, add to the dialogue, and contribute to the growing body of knowledge” about aging.

I imagine Bennett might object to that description. And I’m darned sure she’d object to Pfizer’s sponsorship of this venture as well. (See her recent post, “No Way to Treat a Crabby Elderblogger,” if you have any doubts.)

It’s a savvy move on Pfizer’s part, aligning itself with all those consumer organizations, adopting an attitude of listening to people with an open, curious mindset, positioning itself as a company that helps people live longer and enjoy new experiences. But do not deceive yourself for even an instant: The goal here is to bolster the Pfizer brand and, ultimately, sell more of the drugs that the company links so effectively with longevity and quality of life.

If you have any doubts, see this Pfizer-sponsored video on the company’s “Smart Marketing Page” for the “Get Old” campaign. (I must be getting old: I’ve never encountered a Smart Marketing Page before. I use caps here, as in the press release, to emphatically express the importance of such a page.)

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

Maybe all the participating consumer organizations have received assurances that no cleverly disguised sales pitches will appear on www.GetOld.com and that all information deriving from this project will be unbiased. But, fellow journalists, do you trust that will be the case? And why did so many stories about this initiative ignore that issue and swallow the Gallup & Robinson survey results – the news peg in the press release designed to secure media coverage – hook, line and sinker?

Update:

Bennett sent me some comments about the “Get Old” site after I let her know I was writing this post. I’ve edited them below for length.

“Mostly I object to the website. What a disaster. It violates just about every established guideline for useful, readable, entertaining websites, so much so for elders in both design and content that it’s an insult to us.

As you undoubtedly know, individual elders age at dramatically different rates than people in younger stages of life so that sometimes an 80-year-old’s decline – as in eyesight, for example – can be no more than that of a 50- or 60-year-old. Other times, a 60-year-old can have aged as much as an average 80-something. This also applies to one’s emotional, intellectual and psychic development.

So to section the website by age makes no sense at all, especially when they encourage readers to register their ages so that they can, as the site states, “provide you with stories and information that are relevant and customized for you.” It just doesn’t work that way when talking about elders.

Long before old age, by 40 on average, the majority of us wear reading glasses. But Pfizer has made the text so tiny on their section-front pages, there is no way to know the subject of the item before clicking on it and, even then, the topic is often unclear.

As people age, their eyes have trouble distinguishing between certain colors when they abut one another: red/orange, for example, and blue/green. Yet Pfizer – on that awful “jumble” page of unreadable topics – mixes blue and green boxes that too many elders will blend together.

The site fails aesthetically from page one; there is nothing inviting there, nothing engaging, nothing to pique anyone’s interest. It’s badly conceived and executed.