This piece did an excellent job addressing all of our criteria and fully merited a 5-star rating. We particularly liked how the independent experts quoted in the story provided a more critical and balanced view of the studies’ findings. Our only significant concern is that benefits are described high up in the story in terms of relative risk reduction, while absolute risks are buried far down in the text of the story. This is an issue we discussed in detail in a blog post about media coverage of these studies.
Lipid-lowering drugs, such as statins, are used to help people lower their cholesterol levels, which doctors believe may reduce the risk for heart attacks and strokes. But some people may not get their cholesterol into the recommended range with statins alone, and others are unable to tolerate a lifelong regimen of statins. If an experimental class of cholesterol drugs is shown to reduce cardiovascular risks and improve patient outcomes, then these may prove to be alternatives or adjuncts to the slew of cholesterol-lowering medications already out on the market. On the other hand, the safety of these new drugs must first be ascertained before they become widely available to consumers.
It’s difficult to estimate costs for drugs that haven’t yet been approved by the Food and Drug Administration, so we feel this article did an exceptional job discussing the projected costs of PCSK9 inhibitors. The piece quoted executives at CVS Health who said these drugs may cost $7,000 to $12,000 a year, which may strain health care budgets if many people use them. Furthermore, insurers may be hesitant to pay for PCSK9 inhibitors until there is proof that they prevent heart attacks, strokes and death, it said.
Despite the potential high costs, analysts estimated the drugs will have billions of dollars in annual sales, the article added.
The story did a good job of clarifying the risk of cardiovascular events in each study. For evolocumab, the article said, “After one year, 0.95 percent of those in the group that received the drug had suffered a heart attack, stroke or other cardiovascular problem, compared with 2.18 percent in the group that did not take the drug.” The article went into the same nitty gritty for alirocumab: “After one and a half years, the rate of cardiovascular events was 1.7 percent in those who received the drug, versus 3.3 percent in those who received a placebo.”
We applaud that the piece reported the raw percentages, since it puts the benefits into perspective. But high up in the story, it cites the figures in terms of relative risk reduction, making the benefits sound more impressive: “Both drugs reduced the rate of such cardiovascular problems by about half.”
We encourage stories to report benefits in absolute terms so that readers have a clearer idea of what “risk reduction” really means. And since many readers will not read a long story in its entirety, we encourage journalists to put that information somewhere that readers are likely to see it. If an eye-popping relative risk figure is mentioned high up in the story, it should be accompanied by immediate discussion of what that means in absolute terms.
The article mentioned the drugs could cause memory problems and that long-term safety must still be assessed. The story would have been stronger if it had mentioned the actual rates of memory problems found in the studies. Some mention of the side effects seen with monoclonal antibodies used for other purposes would also have been useful.
The story did a fantastic job cautioning readers on the study’s limitations. The two independent doctors provided much-needed perspectives on the studies’ findings – a contrast from the AP story that quoted an independent expert saying the results were “really impressive.” In The New York Times piece, Dr. Steven E. Nissen said the study did not answer the cardiovascular benefit question definitively. And near its end, Dr. Sanjay Kaul goes specifically into the limitations of each study, such as the alirocumab trial using a narrower definition of cardiovascular events and the evolocumab trial being open label. The story could have done a better job explaining what exactly Dr. Kaul meant by that.
High up in the story, there is immediate notification that the studies were small and preliminary. It also made clear the goals of the studies, which were to assess drugs’ safety and whether they lowered bad cholesterol – “not whether they staved off heart attacks. That could make the conclusions about heart attack and stroke risk less trustworthy,” it said.
These are the statements and perspectives we would love to see more of in health and medical news stories. The New York Times story fully deserves a satisfactory rating here.
The story did not engage in disease mongering.
The story quoted two independent doctors – Dr. Steven E. Nissen and Dr. Sanjay Kaul – both of whom pointed out the limitations in the studies. The piece also did an excellent job in disclosing potential conflicts of interest, since pharmaceutical companies often finance the development and research of their drugs. The article stated that lead study authors “Dr. Sabatine and Dr. Robinson have been paid consultants to the companies sponsoring the trials they led.” It also made clear the fact early in the story that these studies were “sponsored by manufacturers.”
The article briefly compared PCSK9 inhibitors to statins, or other lipid-lowering drugs like Lipitor, stating that this new class of cholesterol drugs reduced bad cholesterol to lower levels than statins. It also mentioned the drug niacin, which did not protect against heart attacks and strokes, despite it raising good cholesterol levels and moderately lowering bad cholesterol.
However, a more thorough discussion on traditional treatments would have been welcome. For example, why are other lipid-lowering medications needed if there are already quite a few out on the market? The AP story addressed this question, explaining many people cannot tolerate statins or get enough help from them.
The article made it clear that these drugs are in development and not approved by the US Food and Drug Administration, but that such approval could come as early as this summer.
The story states that the new drugs are “already known to sharply reduce so-called bad cholesterol.” It explains that the new studies looked at LDL levels for a longer amount of time and tried to address whether these drugs could protect against heart attacks, strokes and other cardiovascular events.
The article did not seem to be based on this press release or this one. The critical perspectives given by the independent experts in this story are evidence of original reporting.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like