This story did a lot of things admirably. The use of independent experts was the most important factor in the story.
We thought the explanation of results was handled awkwardly. But for the most part, this story addressed most of our criteria and deserves a four-star score.
When a study author is a paid employee of the drug company reporting on its own drug, it is crucial that independent experts be called on to analyze the evidence. This story did a good job of that.
No discussion of costs. If the drug has been submitted to the FDA for marketing approval, as the story states, you know that the company has price estimates. It’s the job of journalism to give more cost context.
The following paragraph is a confusing, convoluted presentation of numbers:
“At the outset, when patients spent eight hours in bed, they were typically asleep for 66 percent of that time. One day on suvorexant boosted that by anywhere from 5 percent to 13 percent, relative to the placebo. Between 21 and 37 fewer minutes were spent awake during those sleep periods.”
First, percentages of time asleep were used, then minutes of wakefulness. So the descriptors are switched, leaving readers like us losing sleep.
We were also troubled by a couple of comments:
“There are sleep aids on the market, but they do not work for everyone and they can have side effects that include sleepwalking, daytime drowsiness and confusion.” There is an implied suggestion that Suvorexant will not have these side effects but no data is provided
“Suvorexant works differently from those drugs, zeroing in on specific brain chemicals involved in the ability to sleep, explained study author Dr. William Herring, executive director of clinical research at Merck.” Yes, indeed Suvorexant does work differently than the currently available drugs but suggesting that “zeroing in” on sleep is a bit of an overstatement. The orexin 1 and 2 receptors have been shown in previous studies to effect energy, fluid homestasis, emotion regulation and stress responsiveness to name a few non-sleep effects (Vitamins & Hormones. 89:19-33, 2012)
The story reported:
“there were no serious side effects in this study.
The most common side effects were sleepiness (reported by about 10 percent of patients on the two higher doses of suvorexant), headache (reported by about 5 percent), dizziness and abnormal dreams (5 percent).”
The use of independent experts saved the story on this criterion because those sources added observations such as:
No disease mongering of insomnia.
Two independent sources added needed balance up against the comments of Merck’s director of clinical research.
Strong ending that addressed this criterion:
Another sleep specialist said the findings show “some potential benefit” from suvorexant, but he cautioned insomnia sufferers against relying completely on any drug.
“Medication can be important,” said Dr. William Kohler, who directs the Florida Sleep Institute in Spring Hill. “But in the long run, the best methods for treating insomnia are behavioral techniques.”
Kohler said cognitive behavioral therapy — where people learn to change the thoughts and habits that affect their sleep quality — is a proven way to manage insomnia. For most people, he said, medication should be a temporary treatment; behavior change is the long-term fix.
Bazil agreed: “I look at most people with insomnia as someone who developed bad sleep habits.”
A drug, ideally used for a short time, may help encourage sleep and get people on the right track, Bazil said. “But those bad sleep habits — you’ve got to address them too,” he added.
“The problem,” Kohler noted, “is that we don’t want to make behavior changes. We want to pop a pill.”
The story explained that the drug is “being developed” and has been submitted to the FDA for approval.
One of the independent experts addressed the drug’s relative novelty in this section:
“suvorexant is seen as a potentially important development in the world of sleep medicine, because the drug blocks specific brain chemicals called orexins, which help keep people awake. Standard sleep medications work more widely throughout the brain, Bazil explained, which is why they can have a host of side effects.
“The way [suvorexant] works makes a lot of sense,” Bazil said. “The hope is that it will help some people who haven’t responded to [other drugs], and have fewer side effects.”
It’s clear that the story did not rely on a news release.