Some articles called for enforcement of a mandatory national drug registry of clinical trials. USA Today published an editorial by then-president of PhRMA, Alan Holmer, arguing that efforts to expand access to clinical trial data are already underway and that PhRMA supported the establishment of a central registry that it has encouraged its members to participate in. Similarly, a Washington Post editorial suggested that a requirement to publish all results "might backfire and wind up discouraging companies from conducting any trials at all." Instead, the article encouraged Congress to study the issue and develop a system for disclosing trial results.

Drug importation/reimportation The coverage of importing or reimporting drugs, primarily from Canada, was the third highest covered issue. Primarily, the articles discussed reimportation as a way to cut the cost of prescription medicines for individual patients and to help states and communities balance their healthcare budgets.

Efforts to legalize reimportation or circumvent the existing ban were also commonly reported. According to the Washington Post, "United States Customs estimates 10 million US citizens bring in medications at land borders each year. An additional 2 million arrive annually by mail from Thailand, India, South Africa, and other points. Still more come from online pharmacies in Canada."

A USA Today editorial argued against reimportation, stating that "lifting a ban on Canadian imports would provide little relief" on drug prices, suggesting that a better answer is to inject more competition into the system through a website for price comparisons, pooled buying by states, and more generics. On the other hand, a Los Angeles Times editorial supported a proposal to allow drugs to be imported from pre-approved Canadian pharmacists and wholesalers that have registered with FDA and claimed that the risk of unsafe drugs is "hysterically overstated."

PhRMA issues But that's where the issues highlighted by PhRMA and pharma news ended. The survey showed that only pricing, data disclosure, and drug reimportation—out of the nine issues PhRMA identified on its website—recevied heavy front or editoral page coverage. Four other PhRMA issues received moderate attention in the newspapers: generics, marketing restrictions, intellectual property, and FDA approvals. Manufacturing restrictions and research restrictions, the remaining PhRMA issues, received no coverage at all.

The audit also uncovered 15 articles that focused on ethical or legal issues not included on PhRMA's list. Three stories dealt with the growth of drug counterfeiting, including the production of adulterated or diluted medications and the sale of these drugs over the Internet. Other issues were each covered twice: calls for the National Institutes of Health to ban drug industry payments in the form of consulting fees to NIH scientists; discussions of the merits of experimental trials preceding full-scale clinical study; efforts by pharmaceutical benefit managers/insurers to restrict drugs on the Medicare formulary; and the pros and cons of programs designed to provide AIDS treatments to developing countries.

Headlines vs. Stories Headlines are so influential in shaping public perceptions, and are often all that consumers read or remember in their morning newspaper. The analysis found that, indeed, the majority of headlines opposed the industry: 57.1 percent were negative, 18.1 percent were positive, and 24.8 percent were neutral.

Taken as a whole, the tone of the headlines was less negative than the bodies of the full-text articles themselves. Interestingly, there were a greater number of positive and negative articles compared with the headline analysis, meaning that the headlines were more neutral toward the industry—mostly because they were more general. Although the percentage of favorable articles was only slightly greater than the headlines (20 compared with 18.1 percent), the proportion of articles critical of the industry was much greater, 57.1 percent compared with 69.5 percent. (See "Content Analysis.")