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Lamb to the slaughter

Is daily vilification at the hands of the UK media the best that pharma can expect?

A pile of newspapersAn emotional and educational response to the GMC's criticism of the MMR/autism study, controversy over diet drugs and a new take on an old swipe at the industry – all have been the subject of recent headlines.

'Those whom the Gods would destroy, they first make mad,' said the ancient Greeks more than 3,000 years ago. I was reminded of this as I watched TV news coverage of what should put an end doubts about the safety of the triple MMR vaccine.

In case you're a visitor from Mars, the story is this: after 12 years of controversy since The Lancet published a flawed paper claiming a possible association between the triple MMR vaccine, autism and Crohn's disease, the GMC's code of practice committee issued a damning indictment of the author's conduct and methods.

It said Dr Andrew Wakefield 'showed a callous disregard' for the suffering of children and subjected some youngsters to unnecessary tests. It said he 'abused his position of trust'. He failed to declare his commercial interest. He took blood samples from children at his son's birthday party in return for £5 payments. He faces being struck off.

Yet what do we see on TV news? Parents of the children involved, waving pro-Wakefield banners, and cheering him down the street singing 'For he's a jolly good fellow.' If you are a visitor from Mars, what would you make of earth on your postcard home? If you live here all the time, what do you make of it?

Lessons from MMR
The story provides a number of important lessons on how the general media reports pharma (including biotech and vaccines companies). First, when faced with a battle between science and emotion, emotion wins nearly every time. No surprise there, that's why we offer case studies to illustrate the benefits of new drugs, or to demonstrate unmet need. It's also why the climate change conference in Copenhagen, a scientific gathering, opened with an emotional video of a child looking up at melting polar ice caps.

The MMR saga also follows an honourable media tradition, which has often had negative consequences for pharma: the 'Whistleblower', standing alone for his/her principles, and the only one to know the 'Truth'. It's a well-trodden path in Hollywood, too, as we saw recently with The Informant, starring Matt Damon. Unfortunately, in this case, the 'Whistleblower' was, to quote another scandal, economical with the 'Truth'.

It illustrates that journalists can have their cake and eat it. A number of newspapers have regularly run stories reporting anti-vaccine campaigners' claims, while simultaneously recording health experts' horror at the drop in vaccinations and the rise of cases.

The MMR issue illustrates a suspicion of the scientific establishment and a belief in conspiracy theory. This is another long-standing tradition going back to atom bomb tests in the 1950s, through Thalidomide, salmonella in eggs, BSE and now, climate change. The saga also demonstrates the influence of the SILO. Single Issue Lobbying Organisations are fast-moving, well-organised, clever and know how the media works. They're also successful; the anti-vaccine brigade even got the Prime Minister's family involved. Remember when Tony and Cherie Blair refused to say whether baby Leo had been given separate jabs? Against that kind of clout, what chance does pharma have?

Diet drugs under the microscope
Although you might not think it from the number of alleged adverse events reported in the media, the actual withdrawal of a marketing authorisation is not that common. It happened once in the UK in 2006, 2008 and 2009, and five times in 2007 (including inhaled insulin withdrawn by Pfizer because it wasn't selling).

There has already been one instance in 2010. Reductil was withdrawn (or 'banned' in some media outlets) by the EMEA after a study suggested it could increase the risk of a heart attack or stroke in patients.

The withdrawal brought one of the media's favourite subjects back into sharp focus – so-called 'lifestyle' drugs, and 'diet pills' in particular. It's a topic which poses a dilemma for newspapers with a large female readership like the Daily Mail and the Guardian. They know that losing weight is a popular topic, and many readers are desperate to get back in shape. They also know that many of them have tried prescription medicines, and even bought them on the internet when their BMI hasn't been high enough to get it from their doctor. Running diet stories is a banker, so they regularly report the latest 'fat-busting wonder pill' as one Daily Mail headline described it.

Understandably they're reluctant to criticise the behaviour of their readers. However, the strongest journalistic belief of all is: "If something seems too good to be true, it probably is." So it is with diet pills. In addition, the idea of a 'pill for every ill' society doesn't sit comfortably with the predominantly male, traditional newspaper executives. They deal with it in a number of ways: the most common is to run a 'it happened to me' case study, usually of someone who has allegedly suffered as a result of taking the drug in question. Then when there is a withdrawal they roll out the usual suspects to say 'we warned you it was dangerous' (as well as 'it was too good to be true').

This includes the US-based 'drug safety watchdog' Public Citizen. The organisation was quick to remind readers that it had identified Reductil as a 'danger drug' and had been calling for its withdrawal since 2002. What was not pointed out in the media is that Public Citizen has a long track record of calling for withdrawals, but only a short one of success. Its website currently warns of '204 drugs you should not take under any circumstances' and '62 drugs that can cause eye disease'. How many on the list of 'danger drugs' have ever been withdrawn? Nine since 1997.

Sense of humour failure?
It's always open season on the pharma industry. Barely a day goes by without it being attacked in the editorial pages, by commentators, reports from special interest groups and others, usually with an axe to grind.

This year has brought an attack from another source, a cartoon in the well-respected political magazine The Spectator. It showed a physician in a consulting room saying to a patient, 'I'm prescribing this particular drug because the company gives me lots of lovely freebies.' Why? I could find no reason other than an out-dated and unsubstantiated idea that drug companies bribe doctors. The topic wasn't even in the news. However, my search of The Spectator did lead me to an excellent article in The Times, defending think tanks who take money from pharma companies.

Good news
Finally this month, some positive reporting about two conditions which have been used as examples of 'disease-mongering' by pharma critics.

The Guardian ran a sympathetic feature on Restless Legs Syndrome. As the piece admitted, the name makes the condition sound trivial. So the intro included its medical moniker, Ekbom's disease. The piece included a vivid description of what it's like living with RLS, and provoked a substantial number of comments on the website, all of them with moving tales to tell of their own experiences.

The Daily Telegraph ran a piece on Hypoactive Sexual Desire Disorder (HSDD), usually referred to as 'Female Sexual Dysfunction'. This topic has regularly been quoted as an example of an 'invented disease' since the BMJ first published an article in 2003.

Usually, treatments are referred to in the media as 'female Viagra' so it was heartening to see a whole article about it without those words appearing. The key to both articles was the good stories told by real patients...a reminder for all of us about why the pharma industry is here.

The Author
John Clare is the founder and chief executive of LionsDen Communications
He is a former Daily Mail and ITN journalist, and a published author.

To comment on this article, email pm@pmlive.com

7th April 2010

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