July 20, 2003 - Toronto Star

 Wringing hype out of new drugs

 DON SELLAR

 Newspaper editors in Canada have a love affair with stories about new
 prescription drugs flooding the market.

 No wonder.

 As the Canadian Centre for Policy Alternatives (CCPA) noted recently,
 Canadians spend $15 billion a year on pharmaceuticals. That's more than they
 spend on doctors. [http://www.policyalternatives.ca]

 So it's practically guaranteed there will be high reader interest whenever a
new
 "breakthrough" medicine is unveiled.

 This is especially true as an aging population gets more familiar with scary
topics
 like high cholesterol, influenza, osteoporosis, arthritis and Alzheimer's
disease.

 Sad to say, a CCPA study of 24 Canadian dailies, including the Star, concludes
the
 quality of information being served up about new medicines isn't up to snuff.

 And the early coverage is so "gung-ho" that researchers say it "may encourage
 the immediate use of the drug on a much wider basis than is warranted by the
 scientific evidence."

 The study, funded by a $35,000 grant from the consumer affairs office at
Industry
 Canada, found that articles published in 2000 about five new medicines
frequently
 lacked balance and context.

 "When the benefits were reported, they were often done so in a manner that
 exaggerated the drugs' beneficial effects and downplayed their harmful
effects,"
 the report says.

 "Important information on financial links between researchers involved in
studies
 of new drugs, spokespeople quoted about those drugs, and the drugs'
 manufacturers was very infrequently reported.

 "Additionally, many articles provided little information on costs and drug or
 non-drug alternatives, making it difficult for the public to accurately assess
how
 the drug under discussion might contribute to treatment in comparison to other
 alternatives."

 Led by CCPA research associate Alan Cassels, the study



? Drugs in the News
 ? picked five prescription drugs launched in Canada during the last five years
 amid high media fanfare: Celebrex, for arthritis symptoms; Lipitor, a
 cholesterol-lowering drug; Evista, for post-menopausal osteoporosis; Tamiflu,
for
 influenza and Aricept, an Alzheimer's treatment.

 After sifting through 193 articles, the researchers drew six main conclusions
that,
 to this corner, ought to be a big wake-up call for newspaper editors.

 1. Lack of balance. About 68 per cent of the articles mentioned a drug's
benefit
 but made no mention of possible harm of side effects. No article failed to
mention
 a drug's benefits.

 2. Imprecision. Stories often failed to distinguish between real clinical
benefits of
 a drug, such as reducing heart attacks and fractures, and what are called
 "surrogate benefits." The CCPA report says surrogate benefits are "merely
 changes in some measurement that is only a risk factor for disease, such as
 lowering cholesterol and increasing bone density."

 3. Weigh good and bad. Only a quarter of the articles "quantified the degree of
 benefit or harm associated with the drug." For example, the CCPA report notes
 that in clinical trials, an osteoporosis drug was credited with a 0.8 per cent
 reduction in painful vertebral fractures over three years but a 0.7 per cent
 increase in blood clots in the legs or lungs. Yet articles often called the
drug "a
 proven remedy" to strengthen bones, while noting it caused blood clots "in very
 few." This, the researchers say, is misleading.

 4. Confusing statistics. The report notes journalists often fail to distinguish
 between absolute and relative numbers. For example, it's misleading when
stories
 stress a drug can reduce heart attacks by 33 per cent (a relative number), yet
in
 absolute terms it only cuts the risk to 4 per cent from 6.

 5. Lack of disclosure. The study found only 3 per cent of the stories disclosed
 "the financial interests at work behind the scenes." So readers weren't told
who
 paid for a study about a drug's effectiveness, or whether a patient or
celebrity was
 paid to tout it.

 6. Crucial facts missing. The researchers say 70 per cent of the articles
 included information on approved reasons for using a drug. But only 4 per cent
 gave "contraindications" specifying that certain patients shouldn't take a
drug.
 Only one-third of the articles said how much the drug costs. Nearly half
 mentioned a drug alternative, but only about one article in six mentioned
non-drug
 alternatives such as exercise or diet.

 "Journalists and media outlets ... must ensure that when a new drug arrives on
the
 scene, the Canadian public gets the full story ? the good, the bad, and even
the
 ugly of new pharmaceuticals," the report says.

 This corner has long contended that too often, medical "good-news" stories
display
 a degree of one-sidedness and hype that editors normally find unacceptable in
 other facets of news reporting.

 I also believe some journalists unconsciously allow themselves to be cowed or
 even bamboozled by people who wear white coats and write reports in
 unfathomable jargon.

 The authors of this groundbreaking study of the way larger Canadian dailies
 handle pharmaceutical stories deserve our thanks for putting some statistical
meat
 on anecdotal bones. Readers deserve better coverage.

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