Drug kills flu in a day, news headlines claim. Here’s why that’s bad for public health

A Wall Street Journal story about a new drug that kills flu in a day certainly sounds exciting:

“Japan has approved a drug that its maker says can kill the flu virus in 24 hours, advancing what health experts believe could be a breakthrough in the way the illness is treated,” The Journal reported.

The story claims that the drug, named Xofluza, not only helps people feel better faster, it also potentially reduces how many people get infected overall. This was irresistible to many other news outlets, including USA Today, the Fort Worth Star-Telegram, the Atlanta Journal-Constitution, The Scientist, Forbes and Fortune, which all published second-day stories heavily citing the Journal as their chief source.

But, it remains to be seen if Xofluza will be as effective as its manufacturer wants us all to believe. And it’s unclear if the benefits will be worth the risks, or the costs.

Unfortunately, no news stories we read took the time to spell out these realities, instead focusing only on the most-positive possible outcomes.

This framing — a marketing bonanza for Xofluza maker Shionogi & Co — is a bad set up for American news consumers and our health care system. It’s unlikely that the drug will meet already sky-high expectations, leading to disillusionment and dismay when a more complete portrait of Xofluza eventually emerges.

What do readers need to know that they won’t get from the recent headlines?

Where’s the data?

First, the data. Or more aptly, the lack of data. The study–which was paid for and conducted by Shionogi & Co–actually hasn’t been published in a peer-reviewed journal, meaning the results should be considered preliminary. This is an important point that no journalists mentioned in their coverage.

For now, all we have is a summary of the study that was shared at ID Week 2017, the annual gathering of infectious disease specialists.

This is problematic because it means no one outside of the drug company has reviewed the details of the study, including the rate and type of adverse events. In other words, how many people experienced harms from the drug? And what kind of harms? And how does that compare to its competitor, Tamiflu?

All the study summary tells us is Xofluza compared favorably to Tamiflu, and “was generally well tolerated, with overall incidence of treatment-emergent adverse events lower than that seen with [Tamiflu].”

Harold DeMonaco, MS, a visiting scientist at the MIT Sloan School of Management and one of our expert reviewers, said via email that this is concerning because “we know nothing about severity.” He also pointed out that the study excluded people older than 64, meaning the study was “hardly a representative sampling of the general population.”

With Tamiflu, we now know the side effects can sometimes outweigh the benefits. But it took years for researchers to get a good sense of this–and this will likely be true with Xofluza, too. Journalists should have made readers aware of this big unknown.

The Journal story states that Shionogi plants to seek FDA approval for the drug in the U.S., and as part of that, has another study in the works. But…why? Was this other study not good enough? It’s also a question that needs answering, especially because the FDA is already getting criticized for dragging its feet on approving Xofluza.

“The FDA needs to step up its approval process for this and many other drugs,” one reader commented on the Journal story. Another: “Too bad our FDA here will delay it for years if not decades.”

As we learned with Tamiflu, turning a blind eye to the lack of solid evidence comes at a steep cost. Billions were spent by governments to stockpile a minimally effective drug, which enriched the drugmaker, Roche, but did little for public health.

How well does it work? Does the drug kill flu in a day?

Then there’s the claim that the drug kills flu in a day, which leads to the assumption that people will not just recover faster, they’ll also be less likely to transmit it to other people.

But, as the WSJ and AJC stories pointed out, Xofluza didn’t exactly knock it out of the park, working at about the same pace as Tamiflu to “entirely relieve flu symptoms.”

DeMonaco also said the claim that the drug kills the flu “in 24 hours” appears to be based on the median time–which can be a useful measurement, but in this case isn’t definitive proof the drug is doing what Shionogi claims. (The median value is simply the middle number in a list of numbers, meaning that half of the values will be higher and half the values will be lower.)

“Suggesting that the drug wipes out influenza in 24 hours is misleading and pure marketing hype,” he said.

And it’s anybody’s guess if Xofluza leads to fewer transmissions of the flu–the study wasn’t designed to test that–yet the WSJ didn’t challenge the claim from the drugmaker that the drug could “prevent the spread of infection to others.”

With a serious flu season under way, why the uncritical coverage?

Earlier this month, we reviewed a CBS News/Live Science story of another WSJ article on the same drug. As with the current crop of stories mentioned above, CBS mostly regurgitated what the Journal had to say, instead of doing their own original reporting.

And, in a recent blog post, we also explored how news stories on tragic flu deaths sometimes wrongly portray Tamiflu as a panacea.

These trends are worrying: This year’s severe flu season has been one of the biggest health news stories in recent months. But, instead of getting in-depth reporting, we’re left with clickbait journalism, misinformation, and company talking points.

Don’t readers deserve better?