Complete Health Reporting: Beware of Fishy Claims for New Treatments
It is rare that a drug or device really is novel or that a research finding appears out of nowhere.
Reporters naturally want to focus on newly published research or a new announcement at a conference, but by focusing on one idea, it may present a drug or device as unique when in fact it is just a minor tweak on an old approach or no advancement at all.
Gary Schwitzer, the publisher of HealthNewsReview.org says, “We think it’s naïve and frankly intellectually dishonest to portray something as new when it may just really be old fish wrapped in new newspaper.”
So what sorts of questions do you ask to find out whether the fish is fresh? Schwitzer has a few of those:
“How is it new? What other research has been done in this field? What specifically makes this new idea better? How has this been shown? In how many people? Over how much time? Does the new research conflict with a solid body of evidence that said something else prior to this and how could that be?”
Writers have been asking these questions for several years about the drug Acthar sold by Questcor at more than $70,000 per treatment. David E. Williams at Health Business Blog and Lisa Emrich at Brass & Ivory: Life with MS & RA in particular have been tracking Questcor’s series of price increases and run-ins with regulators.
Russ Mitchell’s writing for the dearly departed Portfolio magazine put together a great piece in 2008 called Drug Money that provided an answer to Schwitzer’s last question: What does the evidence show?
Mitchell interviewed Eric Kossoff, a pediatric neurologist at Johns Hopkins Children’s Center, who had been concerned that children with spasms who had benefited from Acthar would suffer if they couldn’t afford the drug.
Curiously, though, he found that the price hike "was one of the best things that could have happened." Why? "Because we found something better and cheaper." Far cheaper, it turns out. "We spent a few days going through all the medical literature, looking for what works, what doesn’t."
The team turned up a study from the United Kingdom that gave infants high doses of prednisolone, a well-known, generic steroid. Prednisolone had been dismissed as relatively ineffective for infantile spasms-based research that used low doses. The high doses made all the difference: The U.K. study found efficacy rates reached 70 percent and more. Johns Hopkins began using high-dose prednisolone and found it worked in about 70 percent of cases, on par with the hospital’s experience with Acthar Gel. And the price was $15 per injection-essentially free-compared with the three-injection $69,000 treatment from Questcor.
"It was like in times of war, you get focused, and amazing things come out," Kossoff says. "We don’t use [Acthar Gel] at Hopkins anymore for infantile spasms because the oral steroids [high-dose prednisolone] work just as well."
Too few reporters follow Kossoff’s lead and look at the evidence to either prove or disprove claims of a treatment’s novelty. I’ll write about one example in my next post. If you have your own ideas, send them to me at firstname.lastname@example.org or via Twitter @wheisel.
Image by Thomas Levinson via Flickr