Bad Journalism or Bad Pharma?

Bad Journalism or Bad Pharma?

My blogger friend Rich Meyer went on a bit of a rant against "bad journalism" and how pharma is often misrepresented in the news media (see "Bad journalism paints unfair picture of pharma industry").

The drug industry has consistently blamed the news media for painting an "unfair picture" (see, for example, my poll of readers here). I believe, however, that when you look at the evidence, you will find that there is a much higher percentage of articles in major media that paint a "positive picture" of the drug industry and often major news media merely quote verbatim from drug company press releases (see, for example, "The Cymbalta Buzz Machine is at Full Throttle!").

Recently, for example, Boehringer Ingelheim (BI) was chastised by the British Prescription Medicines Code of Practice Authority (PMCPA) for distributing a press release and briefing material for spokespersons that would in effect encourage members of the public to ask their health professional to prescribe a specific prescription only medicine. In fact, several news articles went even further and made some great marketing statements that BI could never make, such as referring to Pradaxa as a "super pill" and a "revolutionary drug." The stories also dissed the competition (warfarin) by referring to it as "rat poison" (see "BI Masters the Art of WOM through Its "Parrots," er, Spokespersons").

These are news stories about pharma products and not about the pharmaceutical industry itself, which is what Rich was focused on. Getting media to publish positive stories about products is very important to pharmaceutical companies. As for stories about the industry itself, well that's why they have the PhRMA trade association, which counterbalances negative stories in the press and competes with news media to influence lawmakers. They have a tremendous budget and the industry shouldn't worry too much about the sort of "bad press" Rich is talking about, IMHO.

In his post, Rich included a graphic image that depicts a TV "spoon feeding" a man sitting in front of the TV with a dazed look. I modified that image to depict how the pharmaceutical industry "spoon feeds" the media as evidenced in the PMCPA/BI case. I call it "Media as Middleman" or "Pharma Feeds Media Feeds Consumers."

Left out of this chain of influence are the Key Opinion Leaders who act as additional "middlemen" and put some further distance between pharma and the media, allowing for "plausible denial" - again as evidenced in the PMCPA/BI case.

Some time ago, I hosted the survey "How to Earn Back the Public's Trust," which asked respondents if they agreed that the media is the main culprit for pharma's bad public image because news media report mostly bad news about the industry and not the good that it does. Obviously, Rich Meyer agrees with this statement. However, only 51% of my survey respondents agreed strongly or somewhat (63% of pharma respondents agreed). While that was a majority, even more respondents agreed that other issues are at fault: such as "lack of transparency regarding negative clinical data" (81% agree) and "high costs of prescription drugs" (81% agree). See a more detailed analysis of this survey here.

Meanwhile, in an FCC Journalism Report, "complaints abound from seasoned reporters who lament the growth of 'press release reporting' and the lack of time they have to check out the veracity of information contained in a press release. Twenty eight percent of health reporters said that they personally get story ideas from public relations firms or marketing outreach somewhat or very often" (see "New FCC Journalism Report Paints Bleak Picture of Health Coverage"). A March 2009 Survey of American Health Care Journalists (AHCJ) found that just under half (44%) of staff journalists participating in the survey say that their organization sometimes (34%) or frequently (10%) bases stories on news releases without substantial additional reporting (see "Academics Exaggerate, Journalists Regurgitate. What About Bloggers?").

IMHO, this is "bad journalism," but of a type that tends to paint a more rosy picture of the pharmaceutical industry and the good it does.

Your Wife, Your Choice - Diapers or Detrol (now Toviaz)?

Your Wife, Your Choice - Diapers or Detrol (now Toviaz)?

Pfizer's @pfizer_news Twitter account just posted this tweet:

"Toviaz top-line primary endpoint results positive in overactive bladder study of nocturnal urinary urgency http://t.co/OU60l6oZ" (see here). 

The link is to a press release that reports the results of a study that purports to show that Toviaz (a reformulation of off-patent Detrol) is "statistically significantly superior to placebo" in treating OAB (Over Active Bladder). The "statistically significantly superior" results were "based on patient self-reporting," which is a very subjective measure of efficacy to say the least.

OAB is one of those "medical conditions" that has been refurbished by the drug industry so that more people -- especially women -- can believe they have a problem requiring treatment by a pill rather than by some other, less invasive, means. I wrote about this before -- see "Overactive Bladder: 'Pharmacia instrumental in creating new disease' says Former VP." Pharmacia was purchased by Pfizer after that post was made.

An anonymous commenter to that post said:

"In the case of OAB, Pharmacia (and later Pfizer and others) provided an acceptable name for the condition, increased awareness, and provided access to effective treatment for a large group of patients (women especially) suffering a hugely difficult condition. Your wife, your choice - diapers or Detrol?"

I thought the last sentence was worth immortalizing in the title of this post because it is said that OAB is one of those conditions that "women especially" suffer from.

The Pfizer press release claims that "approximately 33 million Americans are estimated to suffer from overactive bladder symptoms." It doesn't say how many of these Americans are women, but the Toviaz Web site features a woman posing as a patient ("Not an actual patient") as in this banner:

Yesterday, I asked "Do Women Take More Drugs Than Men Because They Need To or Because They Are Targeted by DTC Advertising?" (see here). Toviaz ads (eg, the Toviaz.com Web site) demonstrate how women are targeted by direct-to-consumer (DTC) advertisers. As I mentioned in yesterday's post, I plan to discuss this in an upcoming Pharma Marketing Talk LIVE podcast discussion tomorrow (see "How to Score With Women (as a Marketer) via Social Media").

One other thing I have to say about the @pfizer_news tweet is that it is an example of a branded tweet that may not comply with FDA regulations because it mentions a brand name drug plus its indication but does not include any "fair balance" (ie, major side effect information) as required by law.

Most pharma social media initiatives such as company blogs and twitter accounts (including @pfizer_news) are managed by corporate communications people who are increasingly taking on the role of brand marketers. These people tend to think of themselves as outside of FDA's purview. Consequently, Pfizer may claim that the Toviaz-branded tweet is notice of a press release, not advertising, and that the press release contains the necessary fair balance (albeit one click away).

In the post about OAB mentioned above, I included slides from a Pharmacia VP that demonstrate the importance of PR and the media in "creating a new disease." One slide said "Drive potential patients to physician offices by using DTC and PR with symptom recognition." Another slide (see below) shows that the Media are an important component in creating consumer demand:

Who Regulates Press Releases? The Case of Bayer's "Melt-in-Your-Mouth" Erectile Dysfunction Tweet

Who Regulates Press Releases? The Case of Bayer's "Melt-in-Your-Mouth" Erectile Dysfunction Tweet

Digital Pharma caught Bayer posting a Tweet - via its @BayerUKIreland Twitter account - that seems to violate new social media guidelines published by the UK's Prescription Medicines Code of Practice Authority (PMCPA), which oversees the self-regulatory code of the Association of the British Pharmaceutical Industry (ABPI).

Here's the Tweet stream that Digital Pharma preserved:

The tweet in question states "First and only melt-in-the-mouth erectile dysfunction (ED) treatment launches in the UK today." It includes a link to a LEVITRA BRANDED press release. I have preserved the press release as a PDF version (here) of the original Web version. I did this because Bayer might remove the original after it reads this post.

The PMCPA code states: "If a company wanted to promote a medicine via twitter it would have to ensure that if the medicine was prescription only, the audience was restricted to health professionals and that the message, in addition to any link to further information, complied with the Code. In addition companies would also have to ensure that recipients had agreed to receive the information. Given these restrictions and the character limit on twitter, it is highly unlikely that the use of this medium to promote prescription only medicines would meet the requirements of the Code. Using twitter to alert health professionals about the publication of a study on a medicine is likely to be considered promotion of that medicine."

As Digital Pharma points out, tweets are viewable by the general public and therefore cannot be "restricted to health professionals" as required by the PMCPA code: "The @BayerUKIreland account has about 500 followers, some are clearly members of the public, but many show no information as to followers’ location or occupation. As an open account all its tweets are on public display and indexed by search engines like Google."

BTW, I could NOT find the tweet by searching Google OR by examining the @BayerUKIreland Twitter stream. That's because Bayer DELETED the tweet according to Digital Pharma. This immediately raised red flags.

But does the Bayer tweet violate the PCMPA code?

In a previous post (see "Brits Beat FDA & PhRMA: Issue Social Media Guidance for Pharma. This BI Tweet May Not Pass Muster") I pointed out that Tweets such as the following from Boehringer Ingelheim (BI) may violate the PMCPA code:

The BI tweet mentions a BRAND name and its indication, but does not include fair balance information. The Bayer tweet, however, does NOT mention a brand name, just the indication and a benefit of a treatment (ie, "dissolves in the mouth in seconds, there’s no need to take it with water and it’s discreet").

Although the Bayer tweet does not mention a brand name, it may still be considered promotion of a drug in the UK. If so, does it violate the PMCPA code? According to Bayer, "Despite the recent publication of a discussion paper from the PMCPA, the position on use of social media and digital communication in relation to prescription medicines remains far from clear."

Bayer's Unregulated Press Release Posted via Twitter is NOT Balanced
Another issue that is FAR FROM CLEAR to me is how the Bayer PRESS RELEASE can pass regulatory muster in the UK. According to Digital Pharma, Andrea Postles (@AndreaPJPostles, LinkedIn public profile), PR & Media Relations Manager at Bayer UK, said: “We have sometimes ‘tweeted’ approved news releases where we know that the content, while of interest, is nevertheless non-promotional, and contains only factual and balanced information."

To which I say BULLSH*T! You can read the "approved" press release here. It is clearly NOT "non-promotional" as Ms. Postles claims.

For example, the first paragraph of the press release states: "Today marks the launch of the first ED treatment available as an orodispersible tablet. In contrast to other drugs of the same class, the new formulation has been designed specifically to be discreet and convenient, has a minty flavour and dissolves on the tongue within seconds."

Here's another example of promotional language found in the second paragraph of the press release: "Levitra orodispersible was developed to help remove the known barriers associated with erectile dysfunction medication by providing men with a more convenient and discreet treatment option which may also help to lessen the embarrassment surrounding the condition."

I'm sold! Where do I get it?

OK, so the press release IS promotional. It mentions the brand name and benefits. But shouldn't it also mention possible side effects and safety information -- ie, the fair balance? Contrary to what Ms. Postles says, the press release does NOT contain "balanced information." There is NO mention of any possible side effects, other treatment options, risks, etc. It's all about LEVITRA and its benefits.

Most pharma product-specific press releases I have seen have a section entitled something like "IMPORTANT SAFETY INFORMATION." The Bayer press release has NO such section. How can it be called balanced?

The importance of PR as a marketing tool has increased DRAMATICALLY, IMHO, with the ascendancy of Twitter and other social media applications.  Pharma corporate communications people seem to be taking a leading role in using social media to promote products while claiming what they do is NOT marketing or promotional. This is a hot topic that I will explore with colleagues in tonight's #socpharm chat at 8 PM Eastern. Join us!

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P.S. @Alex__Butler tweeted this: "@pharmaguy on the broad point of press materials they are public and covered by the code/clause 22; http://t.co/U9FM6UC" which links to the 2011 version of the ABPI Code of Practice for the Pharmaceutical Industry (here). Clause 22.2 states:

"Information about prescription only medicines which is made available to the public either directly or indirectly [my emphasis] must be factual and presented in a balanced way. It must not raise unfounded hopes of successful treatment or be misleading with respect to the safety of the product.

"Statements must not be made for the purpose of encouraging members of the public to ask their health professional to prescribe a specific prescription only medicine."

A press release is information that is intended for journalists with the intent that they will write a story about the information in the press release. Thus, the Bayer press release was made available "indirectly" to the public -- and even directly because of the Tweet linking to the press release.

The press release is "misleading about the safety of the product" because it contains NO SAFETY INFORMATION whatsoever!

Although the press release does NOT directly "encourage members of the public to ask their health professional to prescribe a specific prescription only medicine," the benefit statements made in the press release are simple for the average Joe (or Nigel) to understand and certainly aim to encourage the public to get a prescription of this product.

Pfizer Inc: Working Together for a Healthier Investor™

Pfizer Inc: Working Together for a Healthier Investor™

Pfizer's corporate slogan -- Working Together for a Healthier World™ -- may be "commercially unpromising" and in need of restructuring.

"[Pfizer's research] employees worldwide - along with patients awaiting breakthroughs in therapeutic areas that have been deemed commercially unpromising such as urology, allergies and respiratory ailments - are the losers in a reshuffling of priorities by the world’s largest drugmaker," reported the Financial Times (here).

Pfizer's incoming chief Ian Read plans to continue along the shareholder-pleasing path established by Jeff Kindler, the company's outgoing CEO.

During the past 5 years, "Pfizer returned about $45bn in cash to shareholders while continuing headcount-shredding mergers, most recently with Wyeth," said FT. "Now it will cut an additional $2bn from planned research and development spending to return the savings, and then some, to owners. Already having one of the highest dividend yields in the S&P 500, Pfizer will add $5bn to an existing $4bn share buy-back plan. The move pleased Mr Read’s most important constituency - shares rallied after the announcement."

In light of this, I suggest that Pfizer's new corporate slogan should be: "Working Together for a Healthier Investor™". But that wouldn't sound so good coming from @Pfizer_news, Pfizer's TwitterMeisters, who claim that Pfizer applies "science and our global resources to improve health and well-being at every stage of life." These days it's less about science and more about [financial] resources that power Pfizer.

Media Blackout Imposed by Media People!

Media Blackout Imposed by Media People!

I spent yesterday at Pfizer headquarters in NYC attending and speaking at ExL Pharma's 6th Annual Public Relations & Communications Summit.

I met some of my Twitter pals there including Ray Kerins (@RayKerins), Steve Woodruff (@swoodruff), Mario Nacinovich (@nacinovich), and Zoe Elliott Dunn (@zelliott), among others. I didn't tweet very much while at the conference, but you can use the hastag #prsummit to see what other people were saying during the conference.

One issue many people Tweeted about was the "off the record" rule imposed by Mike Huckman (@MikeHuckman), SVP, Director of Media Strategy at MS&L, during the panel discussion "Exploring How Increasing Demands Placed on a Shrinking Number of Sector Reporters are Affecting Coverage of Health Care Issues."

Huckman also ordered us to shut off our mobile devices and pay attention, which was difficult to do after he imposed the rule that all comments were off the record.

"No quoting... Does anyone know how bizarre this all sounds?" said Len Starnes (@lenstarnes), a nominee for the Pharmaguy Social Media Pioneer Award (see Len's bio).

Christiane Truelove (@ChristianeTrue) said "Still disappointed media panel here was made off the record. Some interesting things were said." She was being polite, as always.

During the Q&A, I noted that all my Twitter buddies were all atwitter about the blackout Huckman imposed and I asked him a simple question: "Why?" His answer was: XXXXXXXXXXXX (redacted).

In a followup tweet to Nacinovich, Huckman said: "Apologies ... 2 those disappointed it was off the record."

"Does 'off the record' exist now a days?!" asked Paulo Machado (@pjmachado). I guess it does for Huckman, who, BTW, is not a candidate for any SM Pioneer Award that I know of.