DRUG COMPANIES DIZZY PRESS WITH SPIN

By: Alicia Mundy Separating Science From PR Isn't Easy


On April 1, 1998, a front-page story in USA Today
trumpeted "Study: No heart damage from diet drug." Just a few
months earlier, the diet drugs Pondimin (the "fen" in the "fen-
phen" combination) and Redux (a "new, improved" version of
Pondimin) had been taken off the market at the urging of the Food
and Drug Administration (FDA). The New York Times and
other papers gave space and happy headlines to this story. Since
about 7 million people took the drugs from 1994 to 1997 and could
be affected, this was good news. Or was it?

In writing a book about the fen-phen scandal, I learned a lot
from the files of Wyeth-Ayerst Laboratories about the use of
medical studies as public relations, the targeting of specific
newspapers and media outlets, and the relevance of positive
medical studies to a company's status with Wall Street. It's
prompted discussions between health writers and me about the
importance of disclosing ties between the studies' sponsors, and
about doing more than rewriting a joyous press release.

At USA Today, reporter Steve Sternberg recalled he was
"appropriately skeptical." The report had been presented at a
convention of the American College of Cardiology. But he called
the FDA and was told they didn't buy the results; the drugs were
dangerous. He included that, but the story still gave the company
a good "bounce" in the news cycle.

Now here's the scoop. When the study's author sent it to The
New England Journal of Medicine, which the company's research
director hoped would publish it, the Journal provisionally
rejected it. Its editor sent a letter to the researcher, Dr. Neil
Weissman, asking him to recalculate his results using the
methodology suggested by the Journal's medical reviewers.
When he did that, the results were quite different. There was a
significant link between heart-valve disease and the drug Redux.

That recalculated study was finally published by the
Journal, along with two others finding the same links with
heart damage, six months later. But this time, the stories in
The New York Times and USA Today didn't get the
same placement. No one noticed that in the one study's case, the
researcher was the same Weissman who, only six months earlier,
had dismissed heart-valve problems.

Most press releases acknowledge drug company funding and
reporters include that. However, in February this year, The
Associated Press ran another story about new studies of these
drugs, and didn't mention that one of them had been sponsored by
Wyeth. Furthermore, one of the co-authors was, in fact, a Wyeth
employee. AP quickly corrected this oversight. But it raises a
question -- if a study includes actual employees of a company
(which happened a couple of times in the fen-phen saga), should
this set off alarms with medical writers?

Finally, that last study, published by the Annals of Internal
Medicine, had an accompanying editorial piece by a doctor
identified only as someone with the University of Pennsylvania.
But, according to a company deposition, Wyeth consults with him.
The doctor said he did not consider himself a "consultant,"
adding that he had divulged his research for Wyeth to the
Annals. Dr. Frank Davidoff, the editor of Annals,
said, "We ask our writers to divulge possible conflicts," but
that he had not considered this link significant. A medical
writer in New Jersey said, "The journal should have identified
the connection, however slight, so we can take it into
consideration in reporting."

USA Today's Sternberg said the war to get independent,
accurate information never ends, noting, "Companies want to use
news columns for advertising." Two years ago, a huge
advertising/PR agency with pharmaceutical ties invested in a
clinical testing company.

How do you tell where the PR drive ends and the real scientific
results begin? "You have to be skeptical," Sternberg said. He
knows quite well that placement, space, and headline can affect a
company's stock price, and influence politicians and the public.
They also can affect how your doctor will treat your problem and
what he or she will prescribe.

One last thing: Look carefully at allegedly independent health-
advocacy groups. Jerome Kassirer, former editor of The New
England Journal of Medicine, asked me to look at the links
between drug companies and groups such as the American Heart
Association and the American College of Cardiology. "When they
send out a press release promoting a study that helps a company's
product, ask how much that company gives them annually," Kassirer
said. "How much does that company support their annual convention
and other meetings in sunny spots? How much research have
individual board members done with that company?" I didn't have
space or time. But maybe your reporters do.



Alicia Mundy's book, "Dispensing With Truth," was just released by St. Martin's Press. Mundy (Mundy007@aol.com) is "The Pack Rat" columnist for E&P, Washington bureau chief for
Mediaweek, and editor at large for Adweek.



Copyright 2001, Editor & Publisher.