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Negative views regarding pharma are on the rise, but vaccines help keep the focus on the positives of innovation
Public reputation has become a key strategic indicator for Big Pharma—and the media plays a subtle but critical role in fixing the criteria by which the industry finds itself evaluated. To set some basic metrics for progress in the biopharmaceutical industry's relationship with the US press, Pharm Exec has for the past seven years commissioned the Arrupe Center for Business Ethics at Saint Joseph's University in Philadelphia to conduct an audit of the hot-button biopharma issues covered in the five biggest circulating US dailies (USA Today, Wall Street Journal, New York Times, Los Angeles Times, Washington Post; see chart) as well as overall attitudes toward the industry and individual companies.
This year's report finds a strong upswing in coverage, with the "top story" being flu vaccines, followed closely by the FDA regarding regulatory issues, and then drug safety. Conversely, interest in drug pricing is down, while the progress of health reform contained less information on industry positioning than was the case last year.
At the top of the list of issues attracting media attention in 2010, for the first time ever, were flu vaccinations. The media's coverage of this issue is telling, as it shifted from alarming reports of vaccine shortages, to the relatively mild strain of the virus, to an oversupply by the end of the year. At the beginning of the cycle, the Los Angeles Times reported a shortage of H1N1 vaccines due to delays and difficulties in production as well as the lack of production within the US. By the end of the review year, the story was the abundant supply of flu vaccines, many of which would go to waste.
Scrutiny and criticism of the FDA and regulatory issues placed second on the list. This issue has ranked first or second for four consecutive years. Next up was the related issue of drug safety. Taken together, these two issues reveal the continuing media scrutiny on the drug approval process, cases of misuse or abuse of prescription drugs, adverse impact, and lawsuits. Most of those articles were critical of the industry and/or a specific pharma company or brand.
Most Reported Issues in 2010
The focus on high drug prices declined in 2010, dropping from third to sixth on the list. Furthermore, two related pricing issues—importation/reimportation of drugs and differential pricing and distribution—did not appear on the list at all. This is an interesting finding in light of reports evidencing drug price increases last year averaging about 9 percent.
Healthcare reform emerged again as a hot issue in 2010. Healthcare reform articles were separated into two populations: one that specifically referred to the response of drug makers to reform (10 articles) and the other that focused more generally on the healthcare reform movement and debate over its provisions (74 articles). In the latter case, status of drug benefits under Medicare and Medicaid got the most attention.
A consistent finding throughout the seven-year study is that articles and headlines tend to be more negative than positive for the industry. The good news for 2010, however, is that the proportion of both negative headlines and negative articles declined significantly from previous years. Nevertheless, as shown in the tables, articles and headlines are still about twice as likely to be negative than positive toward the industry.
Bias Analysis of Headlines and Full-Text Articles
Positive coverage went down in The New York Times, USA Today, and TheWashington Post, while it went up in the Los Angeles Times from zero in 2009 to 22.2 percent in 2010. The articles were also analyzed to determine whether they included the industry's perspective no matter what position taken by the articles' authors. Less than half of the articles in 2010 (34 of 74, or 45.9 percent) included the industry's perspective. This is a substantial decrease from 2009, where 81.3 percent of the articles (13 of 16) mentioned both sides.
Companies mentioned most frequently in 2010 were Merck (13 times), GlaxoSmithKline (13), and Pfizer (12), each involved in major news stories for drug safety and/or efficacy. The results of the trial known as ARBITER 6, questioning the efficacy of Merck's cholesterol drug, Zetia, received ample attention. Similarly, drug safety reports about GSK's Avandia and ongoing troubles with Paxil were reported widely. Johnson & Johnson/McNeil garnered attention after receiving a warning letter from the FDA for a musty or moldy odor of certain products, leading to product recalls of McNeil's children's Tylenol products, including Tylenol, Motrin, and Benadryl.
Next was coverage about merger and acquisition strategies. The brands most frequently cited were Wyeth's Phenergan and Pfizer's Lipitor. Lipitor received extensive coverage as it is the world's best-selling drug and is slated to go off patent later this year.
The media continues to track the industry closely. Yet despite the tendency toward negative coverage, there is recognition of the industry's capacity to develop and implement solutions to medical problems as evidenced by migration of the hot-button issue of flu vaccines to the most-reported issue. This coverage specifically highlighted industry contributions to a public health threat and showcased the challenges facing companies struggling to keep pace with patient and provider expectations—a "cure" for influenza is not simply achieved through wide distribution.
In addition, individual companies continue to shape overall attitudes toward industry reputation, particularly where safety is concerned. Adverse publicity from Johnson & Johnson over the counter-recall initiatives was the driver behind the rise in negative views of the industry last year. The same trend is evident on broader topics such as health reform. Coverage about it was down by 6.1 percent in 2009 and was more neutral (77 percent versus 70.9 percent) last year. However, Republican efforts to rescind the entire bill and the anticipated Congressional debate about implementing key provisions is likely to increase media coverage in 2011—and the partisan nature of the debates to date suggests that coverage will be more polarized. How much damage this does to Big Pharma will depend, in part, on the legality of its promotional activities as well as the visibility of its lobbyists. Assuming there are no off-label promotions and the lobbyists are invisible, adverse publicity may be minimized.
Pharma also now has the opportunity to work constructively with other stakeholders on innovative ways to deliver healthcare, such as states seeking grants to introduce accountable care organizations or to administer the new medical insurance exchanges. This could be a source of "free earned media" if companies play it right by being seen as motivated by a desire to enhance value in the healthcare system.
George Sillup is Associate Professor and Stephen Porth is Associate Dean and Arrupe Fellow at St. Joseph's University. They can be reached at firstname.lastname@example.org and email@example.com, respectively.