Healthcare Reform and Pharma
Following the same methodology, the top five US newspapers were analyzed to shed light on the following questions:
» Do healthcare articles and headlines support or oppose the positions taken by the industry?
» What ethical issues face the pharma industry in these articles on reform?
» How often are the industry's perspectives included in the articles?
» What pharmaceutical companies and/or brand names are identified in the articles?
» What are the implications of these findings for the industry?
For each article reviewed, its headline was judged as positive, negative, or neutral toward the industry. Additionally, each
article was analyzed in the same way. The conclusion was that the headlines were overwhelmingly neutral toward the industry
(88.5 percent) while the full articles were generally neutral toward pharma (70.9 percent)—this despite the articles being
mostly favorable about healthcare reform. (See Table 7.)
Table 7. Analyses of Headlines and Full-Text Articles
The audit found that The New York Times and USA Today were negative toward the industry, while the other three newspapers were primarily neutral toward the industry—particularly
The Washington Post, in which 33 of 43 articles were neutral. (See Table 8.)
Table 8. Analysis of Full-Text Articles by Newspaper
Healthcare Reform and Ethical Concerns
Each article was also analyzed to determine whether it contained any underlying ethical issues specific to the pharmaceutical
industry. The audit found two of note: a subtle bias against high drug prices (19 mentions) and references to the importance
of Medicare/Medicaid coverage for drugs (11). After these two issues, the economy and its connection to paying for healthcare
reform was mentioned five times. Sixteen other issues ranging from insurance accessibility and costs to electronic health
records were mentioned once or twice. (See Table 9)
Table 9. Analysis of Ethical Issues
Coverage was also evaluated to see if it included the opposing point of view. In most cases, this was included.
Assessing the 2009 Audit
The pharmaceutical industry is failing to inspire favorable coverage in two areas over which it has direct control—drug prices
and marketing and sales incentives—which are responsible for 37 percent of media coverage. The industry can get positive or
at least neutral coverage when it talks about price reductions. Significant price increases taken during 4Q 2009, however,
suggest that prices will be a high-ranking issue for the industry again in next year's audit.
Marketing and sales incentives are another issue that the industry can control, but instances of aberrant behavior by individual
companies continues to drag the industry down. Last year's audit noted Lilly's $1.4 billion fine for its off-label promotion
of Zyprexa. Pfizer's 2009 fine—nearly twice Lilly's penalty—suggests that this will remain a hot-button issue. These activities
negate the support the industry gained for its work to provide Congress with a viable alternative for the Medicare drug benefit
in healthcare reform, and suggest that self-regulation isn't likely to protect the industry from legislative action to rein
in its worst practices. Media interest in the human element created by misappropriation of the "public trust" suggests that
coverage of these two issues—pricing and promotion—will stoke the concerns of the political community and challenge the capacity
of the industry to prevail through improved reputational assets.
Stephen Porth is an associate dean, Arrupe Fellow, and professor at St. Joseph's University. George Sillup is an Arrupe Fellow
and assistant professor at St. Joseph's University. Cynthia Slater, Molly Porth, Leanna Baselice, and Courtney Scardellette
also contributed to this research.