Pharma discloses free meals, ProPublica expands database
Filed under: Conflicts of interest, Government, Health care reform, Health data, Health journalism, Hot Health Headline, Member news, Pharmaceuticals, Public records, Tools
In his latest report, ProPublica senior reporter and AHCJ board president Charles Ornstein explains exactly how, since its founding last October, ProPublica’s Dollars for Docs database of pharma payments to physicians has mushroomed from 30,000 entries to more than half a million. They answer, he writes, has a lot to do with free meals and other perks that pharmaceutical companies are starting to publish ahead of strict federal disclosure regulations which will go into effect in 2013.
Pharmaceutical company representatives say the meals serve an important educational purpose, and they have adopted their own set of rules for such interactions.
A voluntary code of conduct adopted by the Pharmaceutical Researchers and Manufacturers of America says that “it is appropriate for occasional meals to be offered as a business courtesy” to doctors and members of their staffs attending information presentations by sales reps.
In such cases, the guidelines say, the presentations have to “provide scientific or educational value,” and the meals should be “modest” by local standards and not part of an entertainment or recreational event. Meals for spouses and take-out meals are not appropriate, the guide says.
To put it all into perspective, Ornstein demonstrates with numbers from Pfizer that, while the meal numbers have certainly increased the number of entries in their database, they haven’t had as significant an impact upon the overall dollar amounts in question.
Relatively, the meals didn’t add up to much money. Pfizer’s meals amounted to only $18 million last year, compared to $34 million for promotional speakers and $108 million for research.
As with previous installments, Ornstein, Tracy Weber and Dan Nguyen’s database work has spawned follow-up reports around the country. In fact, the response was such that Ornstein and Weber even took the step of re-nationalizing the localizations of their story, with the follow-up “News Reports Cite Drop in Physician Speaking Fees.” Below, I’ve linked to a few notable localizations and follow-up stories. If you’ve got another one to point out, add it in the comments.
- A Dozen Pharmas Make Payments to Physicians Public, Kathlyn Stone, About.com
- Drug firms disclose spending on meals, Liz Kowalcyzk, Boston Globe
- How To Find Out If Your Doctor And Drugmakers Are In A Relationship, Scott Hensley, NPR
CPI investigation details health information technology sector’s lobbying efforts
Filed under: Conflicts of interest, Government, Health care reform, Health data, Public records
Writing for The Center for Public Integrity’s iWatch News, Josh Israel reports that, with billions of stimulus dollars still at stake, the number of health information technology lobbyists taking advantage of the lucrative “revolving door” between Capitol Hill and the private sector is sky-high, even by D.C. standards.
The Obama administration is still working to iron out the details of the “meaningful use” mandate expressed in the recovery act, and the big players in health IT are pulling out all the stops to ensure the rules are written to their advantage.
Healthcare Informatics magazine publishes an annual ranking of the 100 largest health IT companies by annual revenue. According to the Senate Office of Public Records, 15 of the companies in the 2010 ranking — most of them ranked in the top third by revenue — reported health IT-related lobbying activity in the first quarter of 2011 or the last quarter of 2010. Of the 90 lobbyists listed as having done health IT lobbying for those firms, at least 63 were former Congressional and/or executive branch staffers, many of whom worked for health-related agencies or committees.
For those interested in additional details on HIT’s lobbying efforts, Israel also included two sidebars:
- Only 15 of top 100 health information technology firms are lobbying on health IT
- Just 16 of top health IT firms maintain corporate PACs
Fla. juvenile justice system relies on heavy antipsychotic use
Filed under: Children, Conflicts of interest, Health journalism, Hot Health Headline
In looking into the state Department of Juvenile Justice’s use of powerful prescription antipsychotics, The Palm Beach Post’s Michael LaForgia “analyzed department drug purchasing information and state Medicaid billing data and reviewed thousands of pages of DJJ inspection reports, drug company disclosure records and court documents.” It shows, as he surfaces with some powerful numbers and equally alarming anecdotes (Part 1, Part 2, Infographic).
…in state-run jails and residential programs, antipsychotics were among the top drugs bought for kids - and they routinely were doled out for reasons that never were approved by federal regulators, a Palm Beach Post investigation has found.
A key concern is that the prescriptions may be driven by their improper use as chemical restraints, or by the hefty speaker (and related) fees being paid from pharmaceutical companies to the most prolific prescription writers. Unfortunately, specifics are hard to come by as most homes are run by private contractors and the state doesn’t have the resources for close monitoring. For this story, the reporters were only able to obtain two years worth of data for 25 jails and three programs – a fraction of the statewide total. Those data still paint what LaForgia calls a “startling story.”
A look at the sheer numbers of drugs purchased … suggests a startling story is unfolding in state homes for wayward kids.
In 2007, for example, DJJ bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children.
That’s enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.
PR rep says journalists’ stipend to attend Allergan event was misconstrued
Filed under: Conflicts of interest, Health journalism
An invitation to journalists to participate in an Allergan-hosted “Facial Aesthetics Advisory Panel” that included an offer of a $250 stipend was misconstrued, according to the public relations representative who sent it.
Sarah Smedley, of Chandler Chicco Companies, said the panel was intended to be “in the nature of a focus group.”
The agency, which sent the invitation to 10 freelancers, wanted the journalists to tell them what types of questions their readers have. Smedley characterized the questions they would put to journalists as broad and not product-specific. Allergan manufactures Botox, Juvederm and Latisse.
They chose freelancers because they have a broad view and write for multiple outlets, according to Smedley. “There was no intention to get stories or coverage; we wanted to listen.”
Two journalists have accepted the invitation but one of them has declined the stipend, she said. “We expected a few to come to participate as experts in the media.”
AHCJ member Lisa Collier Cool shared the invitation with AHCJ, saying she considers this “an all-time low in drug company promotion to the media.”
Karl Stark, AHCJ’s vice president, said the organization’s board of directors was alarmed by the offer.
“We report all the time on the potential conflicts of interest that money creates between drug companies and doctors,” said Stark, a Philadelphia Inquirer editor. “How would this be any different?”
AHCJ’s Statement of Principles includes the advice to:
- Deny favored treatment to advertisers and special interests and resist their pressure to influence news coverage.
- Refuse gifts, favors, and special treatment. Refuse meals from drug companies and device manufacturers and refuse to accept unsolicited product samples sent in the mail.
- Weigh the potential benefits involved in accepting fees, honoraria, free travel, paid expenses from organizers of conferences or events against the desire to preserve our credibility with the audience and the need to avoid even the appearance of a conflict of interest.
“We really regret that Lisa [Collier Cool] misconstrued this,” Smedley said. “The allegation that it was a bribe took my breath away.”
Smedley, who said she has worked in health care public relations for about 15 years, said she was “disappointed that Lisa wouldn’t have called, reached out somehow … for more information.”
She said the invitation has been “misconstrued terribly wrong and out of proportion.”
When asked if she is aware of journalists’ codes of ethics, she replied, “We’re highly aware and we respect journalists and their code of ethics.” She said she also observes the PRSA’s code of ethics.
She does not believe their invitation was unethical and her agency will “conduct focus groups and adhere to codes of ethics, as we’ve always done.” This is the first focus group of this kind for Allergan.
A spokeswoman for Allergan told Forbes’ Matthew Herper that the stipend was “for their participation in a three-hour meeting as a means to compensate them for their time, nothing more.”
PR professional offers cash for attending Allergan-hosted event
Filed under: Conflicts of interest, Health journalism, Member news, Studies
Journalist Lisa Collier Cool was “truly appalled” to receive an email that offered her a $250 stipend if she would attend a “Facial Aesthetics Advisory Panel” hosted by Allergen – makers of Botox, Juvederm and Latisse.
The PR pro, of Chandler Chicco Companies, a health care public relations firm, wrote:
The goal of this Panel is to engage in a discussion about current facial aesthetics trends and innovations, perceived gaps in data, and any questions, concerns or misperceptions your readers may have about products and treatments. Allergan will provide an overview of the evolution of the facial aesthetics marketplace and then will open the panel for discussion.
As a seasoned reporter in this space, we would greatly value your feedback, and we’d like to offer you a stipend of $250 for your attendance and insights.
Cool, who brought the email to AHCJ’s attention, said she considers this “an all-time low in drug company promotion to the media” and that this is the first time she’s received such an offer in more than 25 years of health reporting.
AHCJ’s Vice President, Karl Stark, said AHCJ’s board of directors was alarmed by the offer.
“We report all the time on the potential conflicts of interest that money creates between drug companies and doctors,” said Stark, a Philadelphia Inquirer editor. “How would this be any different?”
Cool agreed, saying she is “shocked that along with questionable payments to doctors, the pharmaceutical industry – or at least Allergan – is now stooping to offering fees to reporters, presumably in the hope of securing favorable press coverage for its products. I view this as a thinly disguised attempt at bribery and hope that this practice won’t become widespread.”
Certainly accepting such money would violate common ethical guidelines for journalists. For example, AHCJ’s Statement of Principles includes the advice to:
- Deny favored treatment to advertisers and special interests and resist their pressure to influence news coverage.
- Refuse gifts, favors, and special treatment. Refuse meals from drug companies and device manufacturers and refuse to accept unsolicited product samples sent in the mail.
The Society of Professional Journalists’ code of ethics advises journalists to:
- Remain free of associations and activities that may compromise integrity or damage credibility.
- Refuse gifts, favors, fees, free travel and special treatment, and shun secondary employment, political involvement, public office and service in community organizations if they compromise journalistic integrity.
“Assisting medical companies with their public relations efforts is not the role of journalists,” Stark said.
AHCJ has contacted the representative who sent the email for details on this arrangement, including whether other reporters have taken her up on the offer, if any reporters have raised questions about it and whether this is an approach she or her company has used in the past. We will update this post if we get a response. [Update: PR rep says journalists’ stipend to attend Allergan event was misconstrued]
Meanwhile, Forbes’ Matthew Herper contacted Allergan and posted its response.
After Fauber’s story, pain group snips industry ties
Earlier this month, we blogged about Milwaukee Journal Sentinel reporter John Fauber’s work linking industry funding, local researchers and the rapid spread of painkiller use in America. Now Fauber’s written the best kind of follow up, with a story headlined “UW group ends drug firm funds.” Here’s the key paragraph:
UW made the announcement after an April 3 investigative report in the Journal Sentinel revealed that its UW Pain & Policy Studies Group had taken about $2.5 million over a decade from companies that make opioids. The money came while the group pushed for what critics say was a pharmaceutical industry agenda not supported by rigorous science: the liberalized use of narcotic painkillers for non-cancer chronic pain.
University officials claim they started cutting off industry funds in September, as part of a successful campaign to regain status as a World Health Organization collaborating center. However, they didn’t disclose that to Fauber during the course of his months-long investigation into the subject, saying that Fauber never asked about it. It’s worth reading the story for a more complete explanation of the change in funding.
Sponsored segments, hospital partnerships creep into news outlets
Filed under: Conflicts of interest, Health journalism
In the St. Louis Post-Dispatch, Blythe Bernhard takes a look at the fruits of the slow, steady advances hospitals and health providers have made into local television and print news. In recent years, sponsored segments and partnered content have insinuated themselves into broadcasts, columns and news-esque advertising spaces.
According to Stacey Woelfel, news director at KOMU-Columbia, Mo., partnership offers are more likely to come from medical institutions than from other sectors. There’s no denying that cash-strapped media outlets have welcomed the extra revenue, and the numbers show that providers have come out ahead as well.
Photo by purple_onion via Flickr
Hospitals that promote their services during news broadcasts say the exposure is more effective than pure advertising. The Mayo Clinic in Minnesota launched its own news department a decade ago to distribute its “Medical Edge” stories to media outlets nationwide. A Mayo survey showed patients’ stated preference for the hospital increased about 60 percent within three years of the news service’s launch. Hospital executives said the business value of “Medical Edge” was more than 10 times the cost of producing it, according to the Columbia Journalism Review.
But media critics, including AHCJ member Gary Schwitzer, say that providing all that valuable exposure may involve ethical compromises on the part of news organizations. After all, they’re ceding some control over the content they air.
“It looks prestigious, it looks clean, it looks expert, but this is information that is coming from and being bought by one medical center source,” said Gary Schwitzer, publisher of Health News Review. “Who has vetted that to say that is the best information, and when are we going to hear from other players in town?”
And, by forming these partnerships, news organizations are allowing hospitals to become the gatekeepers for medical news, and thus indirectly allowing financial concerns to dictate what is considered newsworthy. To illustrate the quandry, Bernhard mentions a 10-month cancer prevention series that was created through a partnership between a St. Louis local hospital and a TV news station. It includes weekly news segments, regular two-minute paid ads during commercial breaks and even monthly phone banks and online chats. Cancer prevention is certainly news, but AHCJ’s president told Bernhard there may be other reasons why it’s driving this particular news and advertising blitz.
Cancer is big business for hospitals competing in a “medical arms race” to attract patients with insurance to fund hospital investments in MRI scanners and robotic surgical instruments, said Charles Ornstein, president of the Association of Health Care Journalists and senior reporter at ProPublica, a non-profit investigative newsroom based in New York.
“There’s a reason they chose cancer instead of diabetes care for the uninsured population,” he said.
Even a medical topic as seemingly straightforward as cancer prevention generates differing viewpoints and requires health reporters to reach out to multiple sources, Ornstein said.
For disclosures of the Post-Dispatch’s own partnerships, see the final subheading, “Popular topic.”
Related
- Research: Local television encourages fatalistic view of cancer
- Ind. station runs ‘canned’ story about Fla. boy
- Hospital says it gives content to short-staffed media
- SF Bay Area station runs sponsored health ‘news’
- Tompkins: Don’t reward station for ethical breach
- State’s paid promotions appear to be newscasts
Online comments lead to BMJ’s disclosure of ‘competing interests’
Filed under: Conflicts of interest, Health journalism
In BMJ, Bob Roehr wrote about a report published by German researchers in the Canadian Medical Association Journal describing an apparent tendency for journals that accept pharmaceutical advertising to publish more positive drug-related articles than those that depend on subscription dollars to pay the bills. The study and the Roehr’s summary are good reading in their own right, but the comment section is where things really get interesting.
There, Age of Autism UK editor John Stone points to a commentary penned by the Alliance for Human Research Protection’s Vera Hassner Sharav and draws into question BMJ’s sources of funding. His main focus is the tension between that publication’s Andrew Wakefield investigations and its receipt of money from an arm of Merck.
Sharav’s language is somewhat incendiary, but it’s BMJ editor Fiona Godlee’s response to her commentary (and Stone’s post) that push the whole thing into the realm of the remarkable. Godlee weighs in on everything right there in the comment thread, admitting that BMJ had not disclosed those conflicts of interest in the Wakefield stories simply “because it didn’t occur to us to do so,” given that it was a story focused on research fraud rather than upon vaccines and medicine.
Although Vera’s claims may seem far fetched on this occasion, she is right that we should have declared the BMJ Group’s income from Merck as a competing interest to the editorial (and the two editor’s choice articles) that accompanied Brian Deer’s series on the Secrets of the MMR scare. We should also, as you say, have declared the group’s income from GSK as a competing interest in relation to these articles. We will publish clarifications.
The whole chain of events is a promising sign that increased interactivity in online publications may lead to increased transparency, and it’s well worth reading, at the very least, all of Roehr’s story and the comments that follow it. All the key bits are there.
Reform opponents got millions from industry
Filed under: Conflicts of interest, Health care reform, Health policy, Hot Health Headline, Public records
Caitlin Ginley, of the Center for Public Integrity, used data from the National Institute on Money in State Politics to demonstrate that the state officials who have joined forces to file a lawsuit challenging American health care reform have, together, received more than $5 million in campaign contributions from hospitals, pharmaceutical companies, doctors and insurers. Among the governors and attorneys general in the 20 states supporting the suit, a few stood out.
… the Center found that top recipients of industry money include Texas Attorney General Greg Abbott, who has received more than $1 million from health care professionals since 1996, and former Georgia Governor Sonny Perdue, who took in at least $970,163 from the industry starting in 1992, when he was a state senator, until he left the governor’s office this week. Other major recipients involved in the lawsuit include former Pennsylvania Attorney General and newly-elected Governor Tom Corbett, who has received about $830,000, and Mississippi Governor Haley Barbour, with more than $770,000.
Ginley provides details on the donations each of those officials received, as well as several others. No word on how this compares to other samples of 40 high profile state politicians. Physician groups and private doctors played a major role in many of the cases she examined.
Taking stock of big pharma in Canada
Filed under: Hot Health Headline, Pharmaceuticals
CBC and Radio-Canada have cooperated to produce a comprehensive look at the nation’s pharmaceutical industry, which centers on Montreal, Canada’s second largest city.
Pharma’s Canadian outposts have sputtered in recent months, and Quebec’s government has struggled to keep the companies in-country.
Part 1: Government incentives to pharmaceutical companies.
Part 2: Regulation of clinical trials.
Part 3: Pharma’s role in continuing medical education.
In addition to the stories, be sure to take a look at the top few comments below the story. Also, the “Quick Fact” box, which taught me that “Montreal has the largest number of clinical trial organizations of any city in North America.”
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