Overzealous Drug Promotions Put Patients At Risk

By Nicholas Regush ABCNEWS.com

Among the big side-shows in the medical business is the annual meeting of the American College of Rheumatology. This year’s brazen pharmaceutical circus, aided majestically by medical reporters, pitched its tent in Boston. By now, millions of Americans, many of them with crippling arthritis, have heard about all the wondrous "breakthroughs," "great medical advancements," "revolutionary new treatment," "no side effects" and "big deals" of magical new potions that the drug industry has unearthed to fight inflammation, joint disease and pain. This seems like a reprise of last year’s dubious big breakthroughs in medicine.

I, for one, toiling in the medical reporting arena now for almost 30 years, am fed up with the brazen outpouring of pharmaceutical company wish fulfillment that goes on at most big medical meetings. What amazes me is how audacious this process has become and how medical media serve as the handmaidens to disgraceful behavior. Whatever disease you have, you have now become a market target for someone’s big-dollar fantasy of how well a drug will work. Medical conventions have become nothing more than podiums for marketeers and their bottom lines.

Who’s Being Held Accountable?

This is not only stupid but also dangerous. When will some of the product champions -- the doctors who make these exaggerated statements to the press -- be held accountable for some of the deaths and injuries that are likely to result from overenthusiastic prescribing of these marvelous new molecular powerhouses? When will medical reporters, their networks and newspapers finally wise up to the simple fact that they are being had?

An article by Trudy Lieberman in the September/October issue of the Columbia Journalism Review focused attention on how the press overplays the positive on new drugs and often ignores the negative. One of her examples dealt with the drug Celebrex, which is marketed jointly by G.D. Searle and Pfizer Inc. Lieberman pointed out how some scientists appearing on network television downplayed the drug’s potential side effects, even though the FDA required a label on the drug indicating that it could cause gastrointestinal bleeding. (In fact, it remains an open question whether Celebrex causes fewer serious gastrointestinal complications than nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen.) Given the strong medical media promotion, Celebrex became a huge seller -- more than 12 million prescriptions since January.

Good News, Bad News

And kudos to the Wall Street Journal for doing some digging on Celebrex. It reported on April 20 that use of the drug had been associated with 10 deaths and 11 cases of gastrointestinal bleeding within three months of its availability in this country. The fact is, these days most drugs are tested only marginally, usually in small numbers of patients and once they get on the market they are soon after prescribed by doctors to hundreds of thousands, even millions. Medical people who say, with a straight face and no qualifying statements, that a newly approved drug is without side effects or that it is an major advancement set themselves up as shills for the drug companies.

People who hear about new drugs on TV news or read about them in the papers should boycott a news organization that allows it to be had by hyperbolic rhetoric. There is no excuse for this type of reporting. News organizations should set up a series of rules that includes qualifying statements about side effects, lack of long-term data on the drug, which is usually the case, and potential for harm on the basis of research the drug company is not likely to make a fuss about. With multimillions of dollars at stake, this is not only a news management issue but also a moral one.

COMMENT: As far as I know, Nick Reglush is the best conventional reporter out there on telling the truth as it relates to health care. I also believe that it is no accident that he works for ABC News who allows him to publish him material.  His article this week provides another perspective on the number one prescribed new drug that was ever introduced into this country. I have no recent data than he quotes, but I am certain that it has killed far more than ten people to date. Celebrex is not the risk free drug that it is being promoted as and should be used cautiously in anyone who is at high risk for heart disease.

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