Newspaper and television reports on new medications tend to exaggerate their benefits, ignore their risks, and fail to disclose their costs, according to a collaborative study in the June 1 New England Journal of Medicine. The study also found that only 40 percent of news stories citing experts with financial ties to the drug being studied disclosed this potential conflict of interest. "Major scientific journals require study authors to disclose industry links, as evidence suggests that commercial funding of research may lead to more favorable research outcomes," says Ray Moynihan, the study's lead author, and an award-winning medical journalist with the Sydney-based Australian Financial Review. "This standard might be adopted by the news media so the public can make more informed decisions on their health care." The study also found that of the 207 stories randomly selected, 40 percent did not offer any numerical analysis of a drug's benefits, leaving the public without any benchmark to judge the overall value of the drug to their health. Of the 124 stories that did, 83 percent reported only relative benefits, a practice that can be viewed as potentially misleading. For example, 1996 reports on a new osteoporosis drug said it would reduce hip fractures by 50 percent, a relative figure that exaggerates the power of the drug when placed next to its absolute benefit. In absolute terms, only two percent of untreated osteoporosis sufferers sustain hip fractures, meaning the new drug would reduce hip fractures from two to one percent of this affected population. Of the stories using figures, only 15 percent mentioned both relative and absolute benefits. Further, 53 percent of the stories failed to discuss potential harms of the three medications included in the study: aspirin, pravastatin, and alendronate. Each drug, while having many benefits, is associated with a range of potential adverse effects. And 70 percent of the stories made no mention of cost-effectiveness, an increasingly important measure of a drug's overall value to society. "The media are a very important source of public health information," says Dr. Stephen Soumerai, a study co-author and HMS professor of ambulatory care and prevention. "But stories on new drugs can be misleading when they fail to address potential conflicts of interest and don't discuss both relative and absolute benefits, risks and costs. We hope this study provides some focus for journalists and editors who are continually striving for greater accuracy in medical coverage." "The media perform a vital service to the public when they accurately report drug benefits and risks and when they identify potential conflicts of interest of experts quoted," says Lisa Bero, co-author of the study, an expert on industry-university relations. Bero is an associate professor of clinical pharmacy at the University of California, San Francisco. Moynihan developed the study while serving as a Commonwealth Fund Harkness Fellow in Health Care Policy in the Department of Ambulatory Care and Prevention (DACP), a joint teaching and research department of Harvard Medical School and Harvard Pilgrim Health Care (HPHC), a Massachusetts-based managed care organization. Moynihan worked with primary mentor and senior researcher Stephen Soumerai, head of DACP's Drug Policy Research Group. Dennis Ross-Degnan of Harvard Medical School, Lisa Bero and Kirby Lee of UC, San Francisco, and David Henry of the University of Newcastle, Australia were also paramount to the study's development, methodology, and conclusions. The study's authors obtained stories on the coverage of the three drugs from 36 U.S. newspapers, including both large-circulation national papers and regional papers, between 1994 and 1998. Approximately 400 stories were reviewed, and 180 were included. From television, coverage from nightly network news and a 24-hour news station was included. Ninety television stories were identified and reviewed, of which 27 met study inclusion criteria. The drugs used in the media analysis were selected because of their strong preventive medicine benefits, potential for consumer interest, and for the large amount of media attention they received. Alendronate, better known as Fosamax, was launched in 1995 for the treatment and prevention of osteoporosis. Pravastatin, or Pravachol, was introduced in 1991 as a cholesterol-lowering drug for cardiovascular disease. Aspirin was included because it was an off-patent drug and has been shown to prevent cardiovascular disease. "The public increasingly wants and needs to make informed judgments about the use of new medications on the market," says Commonwealth Fund President Karen Davis. "This study shows that newspapers and television need to do a better job in reporting about both the benefits and the risks of new drugs." This study was funded through the Commonwealth Fund, a private foundation supporting independent research on health and social issues, and Harvard Pilgrim Health Care Foundation. Note: Lead author Ray Moynihan lives in Sydney, Australia, which is 14 hours ahead of the United States. He can be reached for comment by calling 011-61-2-93653215. He can also be reached by e-mail at [email protected].
