Kevin Lomangino is managing editor of HealthNewsReview.org. He tweets as @KLomangino.
The Wall Street Journal this week explained Why Early Peeks at Drug Trials Are Giving Investors Whiplash.
It’s a thoughtful look at the impact of pharmaceutical company news releases on market psychology and investors.
Here’s how they framed the issue:
To comply with securities requirements of timely disclosure of material information, companies often issue brief “top line” news releases stating whether a study has met a goal, such as prolonging life in cancer patients or preventing heart attacks. Weeks or months later, however, companies often reveal the full details—such as the magnitude of a new drug’s benefit—in medical-journal articles or at medical conferences. If positive top-line results aren’t borne out in the subsequent details, investors sometimes lash out.
That’s interesting as far as it goes but I think the story runs much deeper. It’s important to talk about how those “top line” news releases can end up misleading patients and the public.
We’ve evaluated 420 health-care-related news releases since April 2016, many of them from drug companies. I think that gives us a unique perspective on the influence those messages have on the public discussion about health care.
What we’ve found is that companies often aren’t content to state whether a study has “met its goal” in these news releases as the WSJ reports. They’ll also promote the results with untenable marketing hype while holding back the supporting study data.
The result? News outlets report the hype but ignore issues that would’ve been raised by a deeper examination of the full study. It’s basically free marketing for the company that has only the thinnest of tethers to reality.
Patients and families’ hopes can be raised, only to be dashed when the complete, peer-reviewed study results show that the hype can’t be justified.
We saw this happen with an Amgen announcement about its expensive new cardiovascular drug Repatha. Touted as a “landmark” in an initial news release that our reviewers said “should win a prize for obfuscation,” the complete study eventually showed that the drug reduced heart problems like heart attacks and strokes by 1.5 percentage points compared with placebo — smaller than expected and not enough to impress insurance companies, meaning patients who hoped for access to the drug might not get it after all.
A Reuters story based on that early top line news release shared Amgen’s positive framing, and our reviewers criticized it for reading “more like marketing copy than journalism.”
The WSJ noted that Amgen’s shares “seesawed” after those conflicting messages about Repatha hit the market. But how many patients at high risk of heart disease — not just investors — were also left reeling from the reversal?
This isn’t academic. There are real people — people like Richard Sarti, a glioblastoma patient whom we profiled in a podcast — who are harmed by misleading drug news releases. Richard and his family had a lot more than money riding on the search for a better treatment, and were devastated to hear that a so-called “breakthrough” touted in a news release wasn’t, in fact, anywhere close to being available for clinical use.
Some patients may be similarly misled by a Bayer news release that claims “overwhelming efficacy” for its blood-thinning drug, Xarelto. Our reviewers said the release left out numerous critical details and engaged in unsupported promotion. “In short, it’s like a Superbowl ad for the drug without the all the fast-talking caveats at the end,” they said.
Those complete Xarelto study results haven’t yet been released but there is good reason to be cautious. Some experts say the effect size for the drug is “likely tiny.”
Reuters again toed the company line with its report about the study, claiming “Xarelto proved so effective [the study] has been halted” early. There wasn’t a single note of caution to be found anywhere in the story.
We always share our reviews with the reporters whose work we evaluate. Some wire service reporters have responded that our expectations are unrealistic. They are writing for investors, not consumers, they say, and they can’t possibly include the specifics that we ask for in our story reviews and meet market-focused deadlines.
We think that’s simply wrong, and Reuters itself has done an exemplary job in some of its investor-focused stories that appear to be prompted by company news releases — like this one about a new genetic test for cancer.
Even when a market-moving news release about a study hits from out of the blue, it takes only a few moments to think about and address what might be missing from the promotional announcement. Our review criteria provide a road map.
One wire service reporter wrote to us to describe the mindset that drives their financial coverage (and to make it clear that not all wire service reporters share that mindset). We’ve stricken identifying details from the comments as requested by that reporter:
The only audience [the wire service] cares about is investors. Not consumers, not patients, not thought leaders–only people trying to make money off stock moves. Ergo, if a manufacturer makes a claim about a drug or device, all that matters is that people will read that claim and trade on the stock. The veracity or rigor of the claim is immaterial. That’s why you often see [wire service] stories that parrot claims uncritically: these ‘reporters’ see their job only as being mouthpieces for company claims (e.g. curing hepatitis) that can move a stock. Not all of us do those kinds of stories, but they’re the bread and butter of the operation: ‘screen clients’ in the financial industry who pay for [wire service] news–not media clients who run our journalism–pay the lion’s share of the bills around here, and so they’re the only audience that counts.
We’ve explained time and again why we think investor-focused stories have a responsibility to the larger public. As we wrote in our review of Reuters’ Repatha story:
This story is targeted at a financial/investor audience, yet is widely available online to anyone with internet access, so it will likely be read by patients and others interested in heart disease.
All of these audiences deserve news coverage that’s solid–and not merely unverified hype from the drug company’s news release–since both investors and ordinary readers have something to lose if Amgen’s data, once released, doesn’t deliver on these initial claims.
Our pleas on behalf of patients and the public have largely fallen on deaf ears.
Now that big money is raising a ruckus, maybe somebody will start listening.