Saturday, June 7, 2014

Media Reports on Pharmaceuticals may be Skewed towards Commercial Interests

We are continually, from time to time, informed about how some supposedly independent researchers had in fact received undisclosed payouts from pharmaceutical companies. In more disconcerting news about the undesirable influence of pharmaceutical companies, a review published in the Journal of the American Medical Association has found that media reporting of studies on drug medications could skew public and medical opinion toward commercial interests.



Two factors contribute to this. Firstly, the mainstream media often fails to report the use of funding provided by drug companies for this kind of research. On top of that, both medical and mainstream reporters tend not to use generic names when referring to specific drug medications, but instead use their brand names.

And the study team found that these shortcomings existed even though the editors involved felt otherwise.

Details of Study

The study team, led by Dr Michael Hochman, a resident physician at Cambridge Health Alliance in Cambridge, Mass., had looked at 306 news articles discussing research on drug medications. These articles were sourced from websites as well as United States newspapers, and the studies which were discussed in these news articles had been published in five important medical journals, including the New England Journal of Medicine and the Journal of the American Medical Association.

At the same time, the study team asked 100 editors from the newspapers with the highest readership in the US about their reporting practices.

Findings of Study

The researchers found that 42% of the news articles failed to disclose the fact that drug medication research had received funding from pharmaceutical companies. Even when they did, it was deep within the article and not prominently stated.

67% of 277 news articles which had reported on drug medications only used the drug's brand name at least half the time when referring to the medication. According to the study team, each year, up to $9 billion is spent in the US when medical doctors prescribe brand name drugs, even though a generic would have done the job too.

Compare these figures to the perceptions of the editors – about 88% of them had the impression that news articles which they published often or always stated the presence of company funding. Further, some 77% of them thought that their articles referred to drug medications by their generic name.

It is also worth noting that only 3% of the newspapers in question had formal written policies with regard to the disclosure of company funding, while only 2% had such policies with regard to the use of the generic names of drug medications.

Discussion

Members of the public have the right to expect to be presented with unbiased and objective facts when they read news articles about health and medical research. Unfortunately, that does not seem to be happening, and most certainly not happening enough.

"As a doctor, I am increasingly worried in recent years that company-funded research can't be trusted in the same way that other research can be trusted," said Dr Hochman.

"All of us, doctors, patients, journalists, have gotten into a bad habit of referring to medications by their proprietary brand names. At a philosophical level, I think we need to be referring to them by the generic name. We want to keep commercial interests as much out of the doctor-patient relationship as possible," he added.

Andrew Holtz, independent journalist, former president of the Association of Health Care Journalists, and a former CNN medical correspondent, added to the discussion. "Funding sources should be included in every story where it's relevant," he said.

To be fair, we must take note of one point raised by Holtz – Dr Hochman's study itself may be limited because it only looked at news articles which had a length of at least 200 words.

"Two hundred words is not a very long story and I didn't see in the study anything about whether there was a correlation between length of article and how thorough the article was in mentioning funding and generic and brand names," Holtz said. He added that such articles could also have left out other important information, for example the possible drug side effects.

Moving Forward

Dr Hochman admitted that it would be difficult to use generic drug names over their brand names. This is because many of them are unpronounceable, even for experts, let alone laypeople.

"It's a problem but we're not going to change it unless we take the hard step of trying to learn generic names," he said.

The other issue regarding study funds raised by this study had previously already been discussed by peer-reviewed medical journals. Most of those journals now require researchers to reveal their sources of funding.

"News organizations, in my opinion, really should have explicit written policies that they enforce," Dr Hochman said. "We always need to disclose how a medical study is funded. I'm particularly concerned about commercial studies. We have many examples of how company-led research led us astray."

One specific example which Dr Hochman referred to was Vioxx (rofecoxib) – a scandal erupted in 2004 when the arthritis drug was taken off the market due to concerns that it affected the heart.

In the meantime, readers may have to exercise extra discretion when reading news articles regarding drug medications, realizing that, even though no mention is made, many studies on them may actually have been funded by pharmaceutical companies themselves.