Web outlet pumps out dozens of stories on prescription drug abuse
Filed under: Health journalism, Health policy, Hot Health Headline, Pharmaceuticals, Public health
In partnership with USC’s Annenberg School for Communication & Journalism and a number of other organizations, Santa Barbara online news outfit Noozhawk (about), put together “Prescription for Abuse,” an exploration of the misuse and abuse of prescription drugs in the Santa Barbara area.
In the extensive, online-only series, the reporters take a look at the problem and its underlying causes, then go a step further by exploring possible solutions as well.
In a uniquely meta twist, the series even looks at how journalism such is advancing public health goals and explains how the project came together. The series features at least 36 individual articles, by my count, and every health journalist who takes the time to browse the full catalog will come across at least a few easily localizable ideas, but in this space I’ll just highlight those stories that deal directly with the series itself:
- USC, California Endowment Unite to Support Health Journalism at the Source
- Bill Macfadyen: Prescription for Abuse Project Is a Series of Opportunities
- Santa Barbara Teen News Network Adds Another Dimension to Prescription Drug Abuse Series
- Annenberg Fellowships Take a Diverse Approach to Community Health Journalism
- Bill Macfadyen: Noozhawk Earns a USC Annenberg Health Journalism Fellowship
- Noozhawk Journalists Recount Lessons Learned from Prescription Drug Abuse Series
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
Thieves target pharma cargo, cause shortages
Reporting for WBBH-Fort Myers, Fla., Andy Pierotti reports that highly specialized thieves have made an art form of snatching shipping containers in the state, slipping in like ninjas and getting away with the massive haul in fewer than 90 seconds. They’ll take anything they can get, Pierotti writes, but the big prize is a shipment full of pharmaceuticals.
An intercepted shipment, especially one loaded with rare drugs with tight supply chains, can cause nationwide shortages and price hikes, experts say. And, no matter how esoteric the product, the criminals seem to be able to find buyers.
An NBC2 investigation discovered over the last four years in Florida, thieves stole at least 24 cargo containers full of pharmaceuticals. From dialysis products to eye medicine, they were valued at $5.6 million.
Erik Hoffer, an expert in pharmaceutical cargo crime, says the evidence disappears fast.
“Those pills can be blended into real and fake, there’s no way to trace it anymore and you’ve eaten the evidence,” said Hoffer.
Local hospital administrators say they can feel the pinch when a shipment goes missing, and that the problem has worsened in recent years. There are possible solutions, but their implementation would likely spell more price increases.
Possible remedies to the problem include putting tracking devices on individual pill bottles or cartons, and a consumer interactive tool on the pill box that allows them find out [if] it was reported stolen.
The problem is, that’s expensive and the cost would likely be passed down on the customer.
The stolen drugs pose a health risk, as well. One expert says the stolen drugs can be blended with other drugs and resold, with consumers none the wiser.
In China, pharma hires thousands of doctors to sell drugs
Filed under: Government, Hot Health Headline, Public health
Bloomberg News reports that pharmaceutical companies in China are poaching thousands of trained physicians, many of them recent grads, to become sales representatives in the massive push to take advantage of China’s exploding drug market. The companies can offer salaries that are two to three times those the physicians would earn otherwise, and Bloomberg’s sources estimate that as many as 14,000 more Chinese doctors will become marketers in the coming five years.
The hiring boom is hampering China’s three-year, $131 billion effort to stem a massive shortage of doctors in rural and peripheral areas and provide basic health insurance to at least 90 percent of the population. Paradoxically, it’s that same push, and the demand for drugs that it has created, that’s providing the incentive for big pharma’s Chinese campaigns. One pharmaceutical representative told Bloomberg that China is expected to overtake the United States as his company’s largest market within the decade, and companies have been budgeting accordingly.
Foreign drugmakers like Sanofi and their local affiliates will hire at least 35,000 sales staff by the end of 2014, Aon Hewitt China estimates, based on a survey of 24 companies. The same employers had 33,000 on staff at the end of 2010. About 30 to 40 percent of people recruited for sales jobs will have a medical degree, said Jarroad Zhang, a consulting director with Aon Hewitt in Shanghai.
Reporters find heart devices skipped FDA’s more rigorous approval process
Deborah L. Shelton and Jason Grotto of the Chicago Tribune couldn’t help but wonder: How does a medical device get implanted into patients without first getting FDA approval?
Tricuspid valve in a model heart. (Photo by robswatski via Flickr)
That question led to their two-day series in late May that reported for the first time that certain heart valve repair devices had been “down-classed” from class III to class II, a regulatory category that required that they undergo less scrutiny, even though the devices are permanently implanted and life-sustaining.
One of the annuloplasty rings had been stitched into the hearts of at least 700 patients in Chicago and elsewhere without going through proper channels. In fact, even though the company could have submitted both rings for clearance through a less rigorous regulatory pathway, it didn’t even do that. In these two cases, the process was skipped in its entirety.
In this article for AHCJ members, the pair explains how they reported the story, including finding documents and persuading affected patients to speak on the record.
Ex-pharma rep talks about pressure, tactics to sell
Filed under: Conflicts of interest, Health journalism, Hot Health Headline, Pharmaceuticals
A story reported and produced by Gerri Shaftel at KTTV-Los Angeles (and presented by Christine Devine) gives viewers a look into the world of pharmaceutical representatives, a world of former beauty queens and long lists of off-label uses and side effects.
It’s based around a former pharmaceutical rep and cheerleader named Jennifer Shaw, and opens with the standard portrait of reps as former models with short skirts and even shorter scientific résumés, but also goes into how reps get the information about doctors’ prescribing habits.
Confessions Of A Pharmaceutical Rep: MyFoxLA.com
Over the course of the story, viewers learn how pharmaceutical companies track every prescription a doctor writes, press doctors to raise specific prescription numbers, and rank physicians on a scale of 1 to 100, then reward them accordingly with speaking engagements and the like. Even Jennifer, the rep turned tell-all author, has a compelling story about how she left the industry when her company pushed her to sell a reformulated drug despite the alarming side effects that were cropping up along her sales route.
It may come in a fancy package, but it’s wholesome stuff.
Skyrocketing drug price is chance to examine manufacturing, FDA approval process
St. Louis Post-Dispatch reporter (and Midwest Health Journalism Program Fellow) Jim Doyle has put together a series of stories on KV Pharmaceuticals that read like a primer on the confounding economics of drug manufacture and FDA approval. In the stories, especially the first and last installments, Doyle presents the big picture and helps readers understand why the systems work they way they do.
The first story shows how FDA approval could end up sending the price of a prenatal drug skyrocketing 16-fold and earn piles of money for a local pharmaceutical company. The second involves a U.S. District judge condemning a former head of that same company for “greed, abuse of power, recklessness.” Finally, he ends his tour of pharmaceutical avarice with a stern warning about the potential longterm costs, both monetary and medical, that could result from the fast-track approval of the drug whose approval formed the basis of the first story. For lots more about KV Pharmaceuticals, be sure to check the “Related Reading” box on this page.
Further reading
If you’re looking for more on KV Pharmaceuticals and the Orphan Drug Act, check out Ed Silverman’s post on Pharmalot. There, he interviews a nonprofit advocate who helps explain how KV’s manipulations were possible, how it could happen again and how the act should be modified.
MSNBC: FDA had concerns 2 years before alcohol wipe outbreak, didn’t act
Filed under: Government, Health journalism, Hot Health Headline
JoNel Aleccia and the folks at MSNBC.com have dug in deep on news of the FDA’s Jan. 5 recall of tainted alcohol wipes, spurred on by the death of a Texas toddler and complaints from across the country. Aleccia’s findings seem to indicate that, more than a month after the recall, the case of Triad Groups’ trainted products and related failures of FDA oversight may run far deeper than the original notice implied.
Aleccia’s been helped in the follow-up investigation by unofficial access to FDA records, validated by outside sources, that indicate inspectors detected problems in 2009, and again in 2010, but didn’t act until this year’s recall.
Documents show that FDA officials expressed concerns following visits to the Triad plantfrom July 15 to July 17, 2009, and again from April 19 to May 18, 2010. Inspectors reported that the company could not validate the processes used to ensure quality or sterility not only of alcohol prep pads and wipes, but also other products used for intimate care.
…
The inspection documents, known as FDA Form 483s, were obtained by msnbc.com from a confidential source and confirmed by FDAzilla.com, an independent Web site that monitors the FDA. Copies of the documents were sent to the FDA for review; the agency did not deny their authenticity.
For a thorough roundup of all the points at which warnings surfaced, or at which the FDA could have intervened, check out Aleccia’s full report.
Speaking of FDAzilla.com, it might be a site worth checking out if you’re interested in the FDA’s activities. It’s free and says it has “made millions of pages of FDA data (MAUDE, devices, drugs, 483s listing, FDA employees) more usable and searchable.” The FAQ says most of its data is automatically updated nightly from files posted on FDA.gov.
Australian journal says no to pharma ads
Filed under: Conflicts of interest, Health journalism, Hot Health Headline
Emergency Medicine Australasia, an Australia-based medical journal, has declared that it will no longer accept paid advertisements from pharmaceutical companies.
Image by acediscovery via FlickrThe journal’s editors announced their decision in an editorial, and we learned about it from Pharmalot’s Ed Silverman. In the editorial, the editors say they’re drawing a line in the sand and all but dare other publications to join them. Here’s Silverman with the how-and-why:
The ban followed discussions with other emergency medicine specialists, who worried aloud that advertised drugs were supported by evidence that was neither “of reasonable quality, nor independent.” There were cases of “dubious and unethical” research practices by pharma, including ghostwriting. And academics may face pressure to withhold negative research, which could “inflate views of the efficacy” of heavily promoted drugs.
For more, refer to this AAP story. In this case, the acronym refers to the Australian Associated Press, not the physician group. In Australia, medical journals are one of the only places where pharmaceutical advertising is legal.
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.
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