Health Hazard

Folio: The Magazine for Magazine Management, May 1, 2004 by Rachel Lehmann-Haupt

Byline: Rachel Lehmann-Haupt

Hilary Macht, a freelance writer and former health editor at McCall's, was working at a women's health magazine in the late 1990s when direct-to-consumer pharmaceutical advertising took off. Magazines everywhere were carrying seductive ads for a better life through antidepressants, arthritis drugs, cholesterol busters - and cures for erectile dysfunction. And, because these ads required a lengthy detailed disclosure statement (usually on a second page) along with the uplifting pitch, publishers loved the new category.

Macht's now-defunct magazine landed a schedule of ads from Eli Lilly for its hot new antidepressant, Prozac just when it was planning a big article about depression. The story covered Prozac and included statistics from a study showing that a significant number of patients suffered sexual side effects from the drug. Macht says that word came down from the top of the magazine to cut the sexual side effects from the article for fear that the magazine would lose the ad campaign. "It was a total breach of journalistic integrity," says Macht. "It crossed a boundary that shouldn't be crossed."

DECEPTIVE MESSAGES

That's a gross example of the tricky interaction between health coverage - an increasingly popular subject for all consumer mags, but especially for women's service titles - and pharmaceutical advertising. Editors and writers are wined and dined by pharmaceutical companies and provided with helpful tips on what to cover. Some editors even admit to joining reps on sales calls to show that the product message is being heard by editorial. "It's not that common," says one former health editor. "But once or twice I had an ad rep ask me to come along on a sales call for a little show and tell. There was no direct pressure to do a story, but the client liked that I was hearing the ideas about their product."

These ideas are also handed to editors and writers at informational events and through all-expense-paid trips to conferences sponsored by drug companies. Such events put journalists together with friendly, quotable doctor sources on the drugmaker's payroll. "They hand you everything you need on a silver platter," says Macht. The result, she says, can be a two-fer for the pharmaceutical advertisers: the paid advertisement and editorial coverage that may not give the whole story. The result for the consumer could be a form of journalistic malpractice as even well-meaning editors get taken in by seemingly respectable authorities.

RX FOR MEDICAL JOURNALISM

How much misleading medical information gets into print (and onto TV for that matter) is not known. What is known is that direct-to-consumer pharmaceutical marketing has exploded. A decade ago, most pharmaceutical marketing was aimed at doctors, to encourage them to prescribe certain drugs. In 2003, pharmaceutical companies spent $2.5 billion on consumer advertising - over $1 billion of which went into magazines, according to TNS/Media Intelligence/CMR. And while many other categories swooned between 2002 and 2003, direct-to-consumer pharmaceutical ads in magazines jumped 20.6 percent, according to Universal McCann.

Pharmaceutical advertisers say that consumer marketing allows patients to play a more active role in their health-care decisions. But the ads also send deceptive messages, which has been documented in several studies and has drawn the attention of the FDA (see sidebar).

More problematic for magazine editors and writers is the information planted in health articles by drug companies. In 2000, Ray Moynihan, an investigative journalist, along with academics from Harvard Medical School and the University of California San Francisco, published a five-year study in The New England Journal of Medicine on U.S. television and newspaper coverage of three popular drugs: aspirin; Alendronate, used to treat osteoporosis; and the cholesterol-lowering drug Pravastin.

Although the study didn't assess coverage in U.S. magazines specifically, it found that in half the stories examined, benefits were exaggerated and risks were ignored. In only about one-third of the stories was it revealed that medical sources quoted in the coverage were on the payroll of the pharmaceutical company.

"Too much of what passes for journalism is in fact promotion of drugs, technologies and devices," says Moynihan. "We argue for a change in the culture of medical journalism, which includes routinely mentioning side effects when we mention benefits, and routinely revealing conflicts of interest."

Part of the problem begins with the relationship between the pharmaceutical companies, the public relations firms that represent them and the news outlets. "In the best-case scenario, ad and PR strategies are harmonious and lead to the same goal, which is the patient asking their physician about the drug," says Michael Duran of the public relations firm Porter Novelli, which represents Bristol Myers, Pfizer and SmithKline. "That means maintaining very close relationships with editors."