List date(s) this work was published or aired.
Feb. 10, 2011 July 22, 2011 Oct. 23, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
Feb. 10 story about KV Pharmaceutical’s pricing of pre-natal drug Makena, one of the first and most comprehensive stories that kicked off a national controversy about the company’s pricing and FDA approval of a drug for women with high-risk pregnancies. July 22 front-page daily story on the merger of two giant pharmacy benefit managers — Express Scripts and Medco. Oct. 23 package on charity care and the tax-exempt status of St. Louis area non-profit hospitals, the first in-depth investigation in Missouri of the tax advantages of these multi-billion dollar health systems.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The package on non-profit hospitals relied on IRS 990 forms on multiple companies and their subsidiaries, consolidated audited financial statements, hospital memoranda and correspondence, bond disclosure reports, court rulings, law journal articles, General Accounting Office studies, SEC filings, Federal Aviation Administration records, Medicare cost reports, company brochures, and information posted on the web by business health advocates and hospital trade associations. The initial Makena story relied mainly on human sources, but also incorporated Securities and Exchange Commission documents. Follow-ups relied heavily on FDA advisory committee minutes, Form 990s, correspondence, medical studies, lawsuits, FDA regulations, and law journal articles. The Express Scripts-Medco merger story involved a quick review of SEC documents, news releases, and company web site information. Public records requests were not submitted.
Explain types of human sources used.
The Makena story, and its followups, involved interviews with company officials including KV’s competitors, state health and social service officials, compounding pharmacy executives, FDA current and former administrators, physicians, Senate staff members, law professors, foundation officials, and Wall Street analysts. The Express Scripts-Medco merger story involved in-person interviews and conference calls with company officials, phone interviews with investment analysts, and efforts to reach trade associations and antitrust officials. The package of on non-profit hospitals included inteviews with hospital executives, consumer advocates, Missouri and Illinois tax officials, independent hospital consultants, law professors, and hospital association officials.
Results:
The controversy over KV’s pricing of Makena sparked an uproar from the medical community, which caused the Food and Drug Administration to withdraw KV’s market monopoly, allowing smaller compounding pharmacies to produce low-cost generic equivalents. That decision drove down the price of the drug, making it available to more women with high-risk pregnancies.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No corrections, clarifications or challenges. A dozen follow-up stories probed the Food and Drug Administration’s approval of the drug, despite an advisory committee’s recommendations of further scientific testing; the medical community’s harsh criticism of KV’s price hike; and the financial ties between KV and the March of Dimes Foundation. Follow-up stories on the Express Scripts-Medco merger, including an inquiry by state attorneys general and opposition by independent pharmacy groups.
Advice to other journalists planning a similar story or project.
For beat reporting on the health care industry, my advice is to root out assumptions and triple check your facts. These stories all rely on a ton of numbers, which can prove deadly when wrong. The Makena stories involve a specific medical condition, chemical compounds, and scientific studies, which need to be described with precision. It’s a highly technical specialty, and the powers that be don’t tolerate mistakes.