Lessons Stress Need for Skepticism in Drug Coverage

Rather than healthy speculation, temperate glorification seems to be the theme of how a majority of reporters covered blockbuster drugs recently linked to serious health concerns.

Warning signs of potential harmful effects from the likes of such prescriptions as Vioxx and Celebrex went largely unheeded by reporters on the health and business beats.

According to a recent article in Columbia Journalism Review, "Bitter Pill," contributing editor Trudy Lieberman notes that medical journals raised cautionary flags about Vioxx and other Cox 2 inhibitor drugs as early as November 2000.

The New England Journal of Medicine reported then that a gastrointestinal research study raised suspicions about Vioxx's cardiovascular safety. The Journal of the American Medical Association (JAMA) a few months later conducted research that connected Cox 2 drugs to heart attack and stroke risk.

Merck received a daunting blow last month when a Texas jury awarded the widow of a Vioxx patient $253 million for fatal complications he suffered after taking the drug.

Lieberman says the press failed to further investigate the skepticism published in the medical journals.

"I can't tell you how many stories referred to Celebrex and Vioxx as 'super aspirins,'" says Lieberman, who is also director of the Center for Consumer Health Choices at Consumers Union. "Drug stories demand much more as the truth is a lot more complicated. The media did a great disservice by not putting out the warnings."

Pharmaceutical giants with billion-dollar profit margins and million-dollar public relation machines stand in the way of reporters presenting both sides of the story. These companies have been in the business for a long time and are quite clever at crafting their message.

Add to that a federal bureaucracy that is rather tight-lipped when it comes to regulation and approval of emerging drugs, and the cards are stacked pretty high against business reporters.

"Be skeptical, it is the first rule of journalism," says Merrill Goozner of the Center for Science in the Public Interest. "A study should be seen as a press release in a sense. Reporters need to ask what's the other side of this story."

Goozner indicates that many reporters who cover the medical side of business tend to write stories based on studies. Indeed, they must ask a lot of questions about the origin and funding of those studies.

"Any reporter has got to ask who funded the study and what self interests they might have in the outcome," Goozner recommends. "Then see if there are independent people who know about the disease, the drug and can provide an alternative perspective."

Also investigative the advisory committees and the backgrounds and interests of their members. You can search the ties of various scientists to the industry online at http://www.cspinet.org/integrity/.

Simply put -- follow the money.

Reliable Sources

Keep up to date on what the medical journals are reporting. Bear in mind that these journals often report on funded studies as well. Find the source of the funding. Lieberman notes that these publications have their own checks and balances in place to offer a more transparent picture.

"At least with some of the journals, there is a chance to give a more accurate reflection of the drugs," she says. "Journal articles are also peer reviewed as a layer of protection."

Inside regulatory contacts, while rare, might be chomping at the bit to expose corruption. Dr. David Graham, associate director of the Food and Drug Administration's Office of Drug Safety, ultimately blew the whistle on Vioxx.

Graham testified about the FDA's inability to regulate unsafe drugs when it came to Vioxx. Some estimates put the death toll associated with Vioxx-related heart attacks at 61,000.

Goozner suggests touching base with former officials within the drug companies or regulatory agencies, ex-employees or current workers who may talk to you off the record. Business, science and health reporters can work together to cover all angles of the drug story.

Pay attention to medical professionals who have something credible to say about the effectiveness, or lack thereof, of various drugs.

"There were people within the medical profession with knowledge who were writing on the subject, but it was not a main study," so it wasn't reported on, Goozner says. "The debates that go on in the medical profession on possible flaws are not translating to stories."

As more lawsuits are levied against Merck and other drug giants, reporters should keep the spotlight on the pharmaceutical companies and regulatory bodies that oversee pills that are the lifelines for millions of Americans.

"The story for business reporters is not how the trial lawyer system is out of whack," Goozner says. "Remember that the tort system is the backbone for a failed regulatory system. Clearly, we have this with these drugs."

Copyright © 2008 Donald W. Reynolds National Center for Business Journalism