Tag Archives: Milwaukee Journal Sentinel

Health stories top Investigative Business Journalism awards

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.

Health-related investigations (including one by an AHCJ member) snagged both top spots in the Barlett & Steele Awards for Investigative Business Journalism this year. The awards, funded by the Donald W. Reynolds National Center for Business Journalism, judge stories based on “investigative enterprise, strong business theme, writing style, clarity and impact.”

Reuters’ Murray Waas took the top spot, called the Gold Award, for “Diagnosed with Breast Cancer, Dropped by Insurer (PDF),” a four-month investigation of WellPoint’s rescission algorithm. He’ll get $5,000.

The Silver Award, meanwhile, went to AHCJ member John Fauber, of the Milwaukee Journal Sentinel, for “Side Effects: Money, Medicine and Patients,” the long-running conflict of interest investigation we’ve covered extensively on this blog.

There was no Bronze Award, but another health story — “Inside the Health-Care Crucible: Reports from a Hospital in a Time of Upheaval,” by the Philadelphia Inquirer‘s Michael Vitez — did earn an honorable mention. We’ve mentioned Vitez’ dispatches before, he’s the reporter who spent months “embedded” in a suburban Pennsylvania hospital.

Doctors quietly get millions from device makers

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.

The Archives of Internal Medicine recently published a study on conflict of interest disclosures by surgeons receiving more than $1 million in 2007 from one of any five medical device makers. And by “conflict of interest disclosures,” I, of course, mean “or lack thereof,” a sentiment which would apply in almost half of the cases studied.

The findings mirror similar investigative stories the Milwaukee Journal Sentinel published so, as you might have expected, reporter John Fauber was all over the story.

For the analysis, Rothman and his co-authors looked at publicly listed payments made to doctors in 2007 by five orthopedic firms: Biomet, DePuy Orthopedics, Smith & Nephew, Stryker, and Zimmer.

Using the listed payments, the new study found that in 2007 those companies made 1,654 payments totaling $248 million. The 41 orthopedic surgeon researchers got payments ranging from $1 million to $8.9 million.

Those payments then were used to check disclosures in 95 articles authored by 32 of the surgeons. The disclosure rate was 46%.

Such disclosures will be federally mandated starting in 2013, and Fauber writes that journal editors can already use lists published by device-makers to double-check the disclosures that accompany journal submissions.

Conflicts of interest + off-label use = Blockbuster

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.

Medtronic is back at the FDA, asking for approval of another spine fusion product. Not coincidentally, the Journal Sentinel‘s John Fauber is also hard at work, this time exposing the conflicts of interest and off-label applications which helped make Medtronic’s first spine fuser, Infuse, into a dubious blockbuster.

First approved for a relatively narrow application, Infuse now succeeds thanks to widespread off-label use. It’s key component is BMP-2, a protein which “essentially turned whatever it touched into bone,” Fauber writes.

One recent study found a fourfold increase in the use of all BMP products in five years, from 24,000 procedures in 2003 to 103,000 in 2007. About 85% of that was off-label use, according to the study, which was presented in March at an orthopedic surgery meeting.

If you’re wondering what problems could result from all of these applications, Fauber’s got a story for that too.

According to Fauber, the 2002 Infuse introduction was straight out of the classic drug industry playbook:

First, a buzz is created about a potential new therapy. Then, research – often by doctors with financial ties to the product – is presented to the FDA for a specific use in a narrow group of people. Once the product is on the market, other uses for it are promoted in articles and presentations, often by doctors with financial ties to the company.

And it’s those financial ties, of course, that Fauber is determined to ferret out. He starts with a man whose name (and photo) will already be familiar to Fauber fans: Thomas Zdeblick.

Conflicts of interest involving Thomas Zdeblick, a prominent surgeon at the University of Wisconsin-Madison, are at the heart of the BMP-2 story. He and a small group of doctors from around the country with financial ties to Medtronic have paved the way toward the product’s approval and widespread use.

Zdeblick holds patent rights to a key component of the product and has received more than $22 million dollars in royalties and other payments from Medtronic since 2002. He also is co-author of research reports about the pivotal FDA clinical trial that led to the approval of Infuse.

When Infuse was first approved, it was noted that physicians with financial ties to Medtronic produced results twice as good as those of their independent counterparts. At the time, the panel dismissed it with a joke about how every physician should have a stake in Medtronic, as it sure seemed to improve outcomes. When Fauber tried to find out more about these early concerns and disclosures, however, he ran up against a wall of FDA obfuscation, intentional or otherwise.

The FDA redacted sections of its 2001 file listing the financial disclosures of the Infuse investigators, and it repeatedly told the Journal Sentinel that information no longer was available.

An FDA spokesman first e-mailed this reply: “The information you are asking for was part of the sponsor’s presentation and FDA did not require submission nor did the agency maintain copies.”

Then Friday, a different FDA official said the agency erred and the records were available, but they would be difficult to find.

With a similar BMP-2 based Medtronic product, Amplify, now under consideration, the story of Infuse is more relevant than ever.

Related

J-S settles records suit; docs rebel against COI rules

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.

As a result of the Milwaukee Journal Sentinel‘s now-settled lawsuit against the University of Wisconsin, John Fauber was able to review newly public e-mails which show just how angry a segment of the faculty became when faced with the university’s new, stricter conflict of interest regulations. The regulations came, of course, in the wake of Fauber’s investigative reporting on the subject.

The newspaper’s lawsuit argued that the faculty comments were public records under Wisconsin law and sought a court order to obtain them. To settle the lawsuit, the newspaper agreed to accept the 41 e-mails with the names of the doctors blacked out. The foundation also provided a separate list with the names of the 28 doctors who wrote the e-mails.

The (UW Medical Foundation) also agreed to pay the newspaper’s attorneys’ fees of about $12,400.

The e-mails make for good reading, and Fauber wastes no time in deploying the liveliest phrases in his story.

For example, some physicians complained about the 18-month exemption for orthopedic surgeons and other implanters of medical devices, including one who said “Allowing our docs to shill for device companies is a complete perversion.” An orthopedic surgeon responded with a different take, saying it was “clearly ridiculous” to limit his hourly take from device makers to just $500.

For an explanation from Fauber on how he has been able to consistently produce groundbreaking stories on the conflict-of-interest beat, see the article he wrote for AHCJ.

Boulton explains comparative effectiveness

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.

Next time somebody asks why the stimulus plan included $1.1 billion for comparative effectiveness research (and where all that money’s going), point them to Guy Boulton’s latest explanatory piece in the Milwaukee Journal Sentinel.

In this first installment, Boulton lays a strong foundation for the rest of his “occasional series” on comparative effectiveness by thoroughly answering the “how” and “why” of the massive research effort with carefully selected examples, experts and statistics. No word yet on where the series will go from here, but it’s a promising start.

Tip sheet for AHCJ members

Tracking health-related stimulus money: By Michael Grabell, ProPublica

Journal Sentinel creates overdose database

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.

Tom Kertscher of the Milwaukee Journal Sentinel analyzed 1,200 fatal overdoses that occurred in the greater Milwaukee area over the past eight years and discovered that the majority of them were prescription drug-related. Kertscher puts the statistics in the context of the high-profile death of a local teenager, one which drew significant media attention to prescription drug abuse in the area.

Of the 1,200 deaths, which do not include suicides, just more than half were caused by prescription drugs.

An additional 19% of the deaths were caused by a mix of pharmaceuticals and illegal drugs, such as heroin.

…The victims of the most potent prescription drugs range from urban teens using anti-anxiety medications to get high to middle-age suburbanites who get hooked on narcotic painkillers after being injured on the job. They include residents of all 19 Milwaukee County communities and suburban county residents from Belgium to Kewaskum to Mukwonago.

Kertscher’s overdose database is available online and can be sorted through a search tool or overlaid on a Google map. The map can be sorted by race, age, sex, year and drug type.