Prolific antipsychotic prescribers have industry ties
Filed under: Conflicts of interest, Health data, Hot Health Headline
California Watch’s Christina Jewett compares a list of that state’s top antipsychotic prescribers reimbursed by state Medicaid (obtained through Sen. Charles Grassley, R-Iowa) to ProPublica’s database of educational and speaking fees pharmaceutical companies have paid to doctors.
Not surprisingly, she finds matches. Of the top 10 prescribers, Jewett writes, “Three of them accepted $20,000 or more in educational or speaking fees from the company that makes the drug they prescribe to Medi-Cal patients.” Of those, the most remarkable are a duo who share an office near San Diego:
Samuel Etchie prescribed Seroquel more than 1,000 times in 2009 at a cost of $449,000 to the state, according to Medi-Cal records collected by the ProPublica news organization and provided to California Watch. The drug’s maker paid him $25,350 this year to speak to health professionals.
Etchie did not return two calls to his office.
John Allen, who shares an office with Etchie, was among the state’s top prescribers of Zyprexa, also an antipsychotic drug. Allen dispensed 418 prescriptions at a cost to the state of $346,569. This year and last, the drug’s maker, Eli Lilly and Co., paid him about $27,000 to educate other medical professionals.
The icing on the cake? A quote from Allen:
“I think it’s unfortunate that there’s an implication in articles that we’re robots for drug companies,” Allen said. “We have to have our own experience with medications and find out what works best. We’re not 5-year-olds in front of TV watching cereal and toy commercials.”
New Census data can show way to stories, sources
The Census Bureau will release its American Community Survey five-year estimates on Tuesday, Dec. 14. You can find useful information in the data with just a few mouse clicks – if you know where to look. In this tip sheet, veteran reporter Frank Bass shows you step by step what you can learn from Census data and how to find that information.
That data can help you portray your community accurately by providing a break down of age groups, types of disabilities, poverty status and even how many people have health insurance.
Use the poverty data to identify the communities you should be talking to about urban health problems, such as chronic illnesses and greater complications. Other data will help you determine how many people are covered by certain types of health insurance or how many households are receiving food stamps.
Hospitals to start reporting infection data Jan. 1
Hospitals are set to begin reporting information about hospital-acquired bloodstream infections to the federal government on Jan. 1, with the data becoming available to the public later in the year through the Hospital Compare website, according to an article by Tony Pugh of McClatchy Newspapers. Pugh also reports that hospitals will start reporting on surgical site infections in 2012.
The article includes a graphic that shows what states currently require public reporting of hospital-acquired infections.
While reporting to Hospital Compare will be voluntary, hospitals that fail to comply will “lose 2 percent of their Medicare funding beginning in fiscal year 2013.”
There are nearly 250,000 catheter-related bloodstream infections a year in U.S. hospitals, contributing to roughly 31,000 patient deaths annually. There are more than 290,000 surgical site infections a year, contributing to more than 8,200 deaths.
(Hat tip to FairWarning.org)
Reminder: AHCJ has compiled easy-to-use Excel spreadsheets of much of the data currently available from Hospital Compare. The up-to-date files, available to AHCJ members, are designed to allow you to compare more than three hospitals at a time – unlike the Hospital Compare look-up tool – using spreadsheet or database software to filter, sort and use other analysis tools with precision. You can look at hospital mortality and readmission data, as well as patient satisfaction.
AHCJ will be looking at making the new infection data available to members similar to what it offers for the mortality, readmission and patient satisfaction data.
AHCJ also has tip sheets to help you understand and analyze the data:
- Finding patterns and trends in health data: Pivot tables in spreadsheets
- Intro to investigating health data using spreadsheets
Ind. station runs ‘canned’ story about Fla. boy
Jeremy Cox, medical reporter for the Jacksonville (Fla.) Times-Union, calls our attention to a television report about a boy who suffered a stroke and needed a rare surgery to save his life.
The report, which aired Thursday on WNDU-South Bend, Ind., was produced by Ivanhoe Broadcast News, a media company based in the Orlando, Fla., area.
Cox reports that the story, as aired on WNDU, “features the station’s health logo, ‘Maureen’s Medical Moment,’ along with an introduction and voice-over by the reporter Maureen McFadden.”
Critics have raised questions about these so-called “canned” reports in the past, as Cox points out:
Eric Deggans, the television and media critic for the St. Petersburg Times, asked a poignant question about health journalism a couple years ago. Two, actually.
“As a TV viewer, how do you know when reporters are presenting their own work? And does it matter if the format subtly encourages the audience to think a journalist has done work he has not?” he inquired.
Those questions topped a column about local television news reporters’ habit of presenting health stories produced by someone else as their own work. Without giving credit to that “someone else.”
In a 2009 blog post, Gary Schwitzer, an AHCJ member and publisher of HealthNewsReview.org, says that often stories produced in this way are “almost always about a single idea with one spokesman touting it.”
Certainly stories with a single source that lack independent analysis do not meet the standards set forth in AHCJ’s statement of principles, which calls for vigilance in selecting sources, recognition that most stories involve a degree of nuance and complexity that no single source could provide and seek out independent experts.
How will aging doctors affect your community?
Filed under: Health journalism, Hot Health Headline
AHCJ member Ryan Sabalow, a reporter at the Redding (Calif.) Record Searchlight, recently looked at the age of doctors in his county, finding that “nearly two thirds of Shasta County’s doctors are older than 50, and there aren’t nearly enough young doctors lining up to replace their retiring peers.”
Sabalow freely admits he’s not the first to cover the topic and acknowledges the work of Ventura County Star reporters over the summer. In a Reporting on Health blog post, Sabalow suggests that reporters contact the state medical board and request the an age range of physicians in their county.
The Association of American Medical Colleges forecast that the “passage of health care reform will increase the need for doctors and exacerbate a physician shortage driven by the rapid expansion of the number of Americans over age 65.” For a look at how many physicians are practicing in each state, as well as how many are in school, see the organization’s state-by-state statistics.
Some resources on workforce issues for AHCJ members:
- AHCJ article: How will retiring boomers affect the national health agenda?
- AHCJ article: Caring for aging population will require health care transformation
- Tip sheet: Addressing current and future health workforce hurdles
- Tip sheet: Assessing health reform: Is there a looming doctor shortage?
- Report: VA facilities face shortage of nurse anesthetists
- Report: Preparing for aging boomers
- Report: AAMC’s 2009 workforce report
- Award entry: ‘State struggles with primary care workforce incentives,’ KHI News Service
- Presentation: The Health Workforce Dream Team: Who Will Provide the Care?
Barlett & Steele uncover chaos, peril of global drug industry
Filed under: Conflicts of interest, Europe, Government, Health data, Health policy, Hot Health Headline, Pharmaceuticals, Public health
In Vanity Fair, Donald Barlett and James Steele have devoted more than 6,000 words to chronicling the gaping holes in the global pharmaceutical industry, particularly as pertains to the globalization of clinical trials. Even if you’re familiar with many of the specific incidents covered, their cumulative effect, driven home with forceful and authoritative prose, is brutal. Each paragraph holds another tale of trials gone wrong, children killed and bad results that somehow never came to the attention of American regulators.
Photo by amyvdh via FlickrIt used to be that clinical trials were done mostly by academic researchers in universities and teaching hospitals, a system that, however imperfect, generally entailed certain minimum standards. The free market has changed all that. Today it is mainly independent contractors who recruit potential patients both in the U.S. and—increasingly—overseas.
They devise the rules for the clinical trials, conduct the trials themselves, prepare reports on the results, ghostwrite technical articles for medical journals, and create promotional campaigns. The people doing the work on the front lines are not independent scientists. They are wage-earning technicians who are paid to gather a certain number of human beings; sometimes sequester and feed them; administer certain chemical inputs; and collect samples of urine and blood at regular intervals. The work looks like agribusiness, not research.
After neatly setting up each pin with demonstrations of how international the pharmaceutical industry has become, then proceed to knock them all down with examples of industry impunity and FDA weakness.
The F.D.A., the federal agency charged with oversight of the food and drugs that Americans consume, is rife with conflicts of interest. Doctors who insist the drug you take is perfectly safe may be collecting hundreds of thousands of dollars from the company selling the drug. … Quite often, the F.D.A. never bothers to check for interlocking financial interests. In one study, the agency failed to document the financial interests of applicants in 31 percent of applications for new-drug approval. Even when the agency or the company knew of a potential conflict of interest, neither acted to guard against bias in the test results.
Related
WikiLeaks cables: Pfizer used dirty tricks to avoid clinical trial payout in Nigeria
Fellows learn about BRFSS data on trends in health
This is a guest post from Lara Salahi, of ABC News. She is one of 11 AHCJ-CDC Health Journalism Fellows visiting the CDC this week.
I’ve been assigned the disease topic, perhaps even given the gist of the headline. And now I’ve got a few good hours to meet my deadline.
The 2010 AHCJ-CDC fellows take a break from their busy week in Atlanta. They are: (front row) Raymond Hainer, Health.com / Time Inc.; Meredith Matthews, Current Health Teens magazine/Weekly Reader; Ruby de Luna, KUOW-Seattle Public Radio; Kevin McCarthy, Consumer Reports/Consumers Union; (second row) Margaret Haskell, Bangor Daily News; Felice Freyer, The Providence Journal; Katherine Harmon, Scientific American; (back) Lara Salahi, ABC News; Rong Lin II, Los Angeles Times; Miranda Van Gelder, Martha Stewart Living; and Jori Lewis, freelance journalist & radio producer.
The patient story: compelling.
The expert opinion: piece of cake.
But finding accurate and current data that will pull the story into perspective? Suddenly I can hear the minutes taken from writing ticking away, one hour of research at a time.
Chalk this scenario up on the list of “You know you’re a daily reporter/producer when…” you’re the only one who wishes there were more hours in a workday.
Readers and viewers want to know how common a health issue is in their state, or whether a health trend has increased or decreased over time.
The CDC website is so expansive; it’s hard to tell where to start. But the Behavioral Risk Factor Surveillance System, or BRFSS, is a quick link to bookmark. BRFSS publishes annual prevalence and trends data on health issues such as diabetes, health care access, and oral health.
Lina Balluz, acting director of the Division of Behavior Surveillance at the CDC’s National Center for Chronic Disease Prevention and Health Promotion, walked the AHCJ-CDC Health Journalism Fellows through finding the analyzed self-reported data from telephone-based questionnaires.
BRFSS is one of the fastest data collection methods analyzed on a given health issue, said Balluz. The system includes national data, stratified by states. It’s one tool that may help add perspective to a story and cut the time spent searching.
Editor’s note: For help finding additional information on the CDC website, we recommend AHCJ’s “Navigating the CDC: A Journalist’s Guide to the Centers for Disease Control and Prevention’s Web Site.”
Other dispatches from the AHCJ-CDC Health Journalism Fellows:
- Expect developments in screening, treatment for hepatitis C
- CDC: Cholera has spread throughout Haiti
- Diabetes project coming from the CDC
AHCJ-CDC Fellows learn about diabetes project
Editor’s note: This post, from the AHCJ-CDC Health Journalism Fellows‘ visit to the CDC, originally reported the CDC is close to launching a diabetes project. In fact, the National Diabetes Prevention Program launched in April 2010 and the CDC continues to expand the program, which currently has 28 sites.
The Diabetes Prevention Program clinical trial, according to the CDC, is “designed to bring evidence-based programs for preventing type 2 diabetes to communities. The program supports establishing a network of lifestyle intervention programs for overweight or obese people at high risk of developing type 2 diabetes,” including dietary changes, coping skills and group support. More information about lifestyle interventions is available from the YMCA and UnitedHealth Group.
More about the visit to the CDC:
Meredith Matthews, of Current Health Teens magazine/Weekly Reader, wrote a blog post wrote about the visit, reporting that the fellows visited the CDC’s emergency operations center, which is monitoring the cholera outbreak in Haiti. They also heard from CDC director Thomas Frieden, M.D., who Matthews says answered all of the fellows questions.
Other dispatches from the AHCJ-CDC Health Journalism Fellows:
- CDC: Cholera has spread throughout Haiti
- Expect developments in screening, treatment for hepatitis C
CDC: Cholera has spread throughout Haiti
Ron Lin, of the Los Angeles Times, reports that cholera has spread throughout Haiti, according to CDC officials speaking to the CDC-AHCJ Health Journalism Fellows in Atlanta yesterday.
The disease, caused by a bacteria that spreads through tainted drinking water, also is turning up in the Dominican Republic. A Dec. 8 Morbidity and Mortality Weekly report says 91,770 cases have been reported nationwide and 43,243 patients had been hospitalized. More than 2,000 have died.
At a community training event in Haiti, aid workers demonstrate how to make a rehydration solution for a patient with cholera.
Photo by EDV Media Director via Flickr
The report comes a day after the Associated Press reported that a contingent of U.N. peacekeepers was the likely source of the cholera outbreak, citing a report written by a scientist who was sent by the French government to assist Haitian health officials.
Soldiers who arrived at the U.N. base, upstream from where the first cases of cholera were reported, soon before the cholera outbreak came from Nepal, according to the story.
Dr. Jordan W. Tappero, director of the Health System Reconstruction Office at the CDC’s Center for Global Health, did tell reporters that the CDC did analyze the cholera strain in Haiti and identified it as a strain that is circulating in South Asia.
Lin is one of 11 AHCJ-CDC Health Journalism Fellows visiting the CDC this week. The fellows are attending sessions on epidemiology, global disease prevention efforts, pandemic flu preparedness, climate change, vaccine safety, obesity, autism and have toured the CDC director’s National Emergency Operations Center.
Other dispatches from the AHCJ-CDC Health Journalism Fellows:
Expect developments in screening, treatment for hepatitis C
This is a guest post from Felice J. Freyer, a medical writer at The Providence (R.I.) Journal. Freyer, an AHCJ board member, is one of 11 AHCJ-CDC Health Journalism Fellows visiting the CDC this week.
Felice J. Freyer
One in 30 people born between 1945 and 1965 – the Baby Boom generation – suffer from hepatitis C, a viral infection that can lead to liver cancer.
But the majority of infected people don’t know they have it.
That may change soon, and journalists should keep their ears perked for developments that will lead to good stories about hepatitis, Dr. John Ward, director of the Viral Hepatitis Program at the U.S. Centers for Disease Control and Prevention, told the AHCJ-CDC Health Journalism Fellows this morning.
The CDC is in the process of developing screening guidelines in the hope of encouraging more people to get tested for hepatitis C. Current guidelines call for asking people about risk factors, such as intravenous drug use, that many may not want to disclose or consider part of their distant past, Ward said. The new guidelines may be based on age and other factors rather than just behaviors, he said.
Additionally, the FDA is considering approval of a new, more effective drug against hepatitis C. “We are on the cusp of a revolution in hepatitis C treatment,” Ward said.
The 11 AHCJ-CDC fellows today completed the third of four days at the CDC, where they have met with CDC experts on food-borne illness, diabetes, influenza, health care-acquired infections and other topics, as well as touring the CDC emergency operations center and laboratories in Atlanta.
Other dispatches from the AHCJ-CDC Health Journalism Fellows:
-
Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
