Note to our followers: Due to a lack of sufficient funding, HealthNewsReview.org will cease daily publication of new content at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. If you wish to donate, your gift might help keep the site available to the public for a few more years, by defraying costs of web hosting and maintenance. All of our 6,000+ published articles contain lessons to help people improve their critical thinking about health care. Read more about our change in status. And here's how to make a donation.
Read Original Release

Here’s a prime example of how Big Pharma issues misleading news releases to journalists

Rating

3 Star

XARELTO® (rivaroxaban) Associated with Significantly Reduced Time in Hospital and Decreased Costs Compared to Standard of Care in New Study of Patients with Low-Risk Pulmonary Embolism (PE)

Our Review Summary

iStock / Getty Images Plus

The news release is about a study that explores if patients with pulmonary embolism, a blood clot in the lungs, who are at low risk for complications can be sent home from the emergency department early rather than be admitted to hospital. The patients were divided into two groups: One group of patients were sent home early while taking rivaroxaban (Xarelto), a type of blood thinner, whereas the “usual care” group could get any blood thinner of their physician’s choosing, including rivaroxaban, and hospitalization.

The study findings suggest that early discharge of low-risk patients was safe and feasible and also resulted in cost savings because of less time spent in hospital. Unfortunately, the news release seemed to suggest that it was the use of rivaroxaban that resulted in cost savings–rather than the strategy of sending low risk patients home early. The news release failed to state was that over half the patients in the comparison group who got usual care also received rivaroxaban.

In other words, the news release implies that rivaroxaban was being compared to other anti-coagulants when what was actually being compared was an early vs. late discharge strategy.

 

Why This Matters

Janssen’s misleading news release could result in news stories trumpeting rivaroxaban as a superior blood thinner, when that is not what this study looked at.

Criteria

Does the news release adequately discuss the costs of the intervention?

Satisfactory

The news release acknowledged that there would be a cost savings associated with the early discharge group. But, adding in the cost of the drugs used in the study would have been useful.

It’s worth noting that the modest case savings reported here might be considerably larger if a generic blood thinner is used.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

Both primary and secondary efficacy outcomes are listed:

Primary: patients who received Xarelto spent less time in the hospital due to blot clots — either in deep veins (DVT) or the lungs (PE) —  when compared to the standard of care (SOC) within the first 30 days of treatment (4.8 vs. 33.6 hours, respectively).

Secondary: No recurrence of venous thromboembolism (VTE), or VTE-related deaths … or any significant differences in the bleeding-related hospitalizations … or physician visits … within the first 90 days.

It requires a close reading of this news release, and the study, to realize that this should have been framed as early discharge while on a blood thinner did not result in harmful outcomes compared to patients who were admitted and had longer hospital stays. We’ll address this issue under quality of evidence, below. However, the release did provide quantification of benefits so it squeaks by on this one.

Does the news release adequately explain/quantify the harms of the intervention?

Satisfactory

This news release does provide a section on the side effects and drug interactions of Xarelto. It also could have mentioned some of the risks of early release from the hospital.

Does the news release seem to grasp the quality of the evidence?

Not Satisfactory

While this news release describes the study with reasonable accuracy, one glaring omission is the fact that they neglected to mention that most of the usual care group also got rivaroxaban. In effect, attempting to spin this study to suggest that rivaroxaban was better than its competitors in treating pulmonary embolism is a rather significant mischaracterization of what the study attempted to demonstrate, which was the safety of an early discharge strategy compared to keeping patients in the hospital.

Does the news release commit disease-mongering?

Satisfactory

No disease mongering. Pulmonary embolism is a relatively common disorder with a very wide range of severity and mortality.

Does the news release identify funding sources & disclose conflicts of interest?

Not Satisfactory

It’s made somewhat clear that both the news release and the study are sourced from Janssen Pharmaceutical Company (who’s developing rivaroxaban with Bayer).

However, the principal investigator quoted in the release has financial ties to the company, which should have been disclosed.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

There are other blood thinners used in patients with PE, but the release doesn’t name any of them.

Does the news release establish the availability of the treatment/test/product/procedure?

Satisfactory

The news release states that the current research adds to previous studies dating back to 2015, and that rivaroxaban is currently being used to reduce the risk of blood clots in people with atrial fibrillation and deep vein thrombosis (or, DVT).

Does the news release establish the true novelty of the approach?

Satisfactory

The vice president of scientific affairs for Janssen Pharmaceuticals is quoted in the news release as saying the research is “the first prospective randomized trial” to investigate discharging emergency room patients with low-risk pulmonary embolism” (LRPE). It also gives some background on an earlier study to establish that this isn’t a brand new idea.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Not Satisfactory

The headline of this release crosses the line into unjustified language. It credits rivaroxaban with reducing the time patients spent in the hospital, when the early discharge strategy was actually the main difference between the groups — not the use of rivaroxaban.

Total Score: 6 of 10 Satisfactory

Comments

We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.

We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.