Blurring the boundaries
Authors: R. Moynihan
Journal: BMJ (2003)

In the field of medicine, finding the line between education and promotion is often a daunting task, as industry sponsored events and materials dominate so many of doctors' postgraduate learning experiences.

If recent developments in the United States media are any indication, a whole new blurring of boundaries is also happening within the world of medical news.

Take the innovative New York based Healthology, founded by former advertising executive Dr Steven Haimowitz. Boasting 40 staff, the company makes highly accessible videos about medical conditions and treatments featuring leading physicians. These are available as “webcasts” on more than 4000 websites around the world, including the sites of news organisations such as America's ABC News and disease groups such as the International Multiple Sclerosis Support Foundation.

Haimowitz told the BMJ earlier this week that his video programmes used the latest technology to give ordinary people access to top experts in the field. “It's the next best thing to having a visit with a thought leader.” So should this be called news? “Absolutely not,” Haimowitz emphasised. “We are not a news service... We are a health content company, we distribute content across the web.”

Yet despite these claims by the president and chief executive officer, Healthology's medical programmes are made to look an awful lot like they are news. The company's own publicity says, “Most programmes are produced in a newsmagazine style.” Moreover the company hires well known news journalists to present its short magazine pieces, and its programmes are widely available on the websites of highly respected news media.

What many viewers of these “newsmagazine” style programmes may not realise is that healthcare companies, including pharmaceutical and biotechnology companies, are directly paying for Healthology's videos and suggesting the topics to be covered, according to a report in the New York Times last week. That article named a number of senior American broadcasters, including the famous former CBS anchor Walter Cronkite and Sixty Minutes presenter Morley Safer, as having worked for another company called WJMK, which like Healthology is funded by pharmaceutical giants to make video material. The celebrity journalists were reportedly paid up to $100 000 for one day's work recording segments for WJMK, which were then broadcast as news on public television stations across the country. WJMK did not respond to BMJ requests for an interview.


“Every one of the drug companies has these organisations that front for them”


Healthology argues strongly that its sponsors don't control content, and its material is not promotional. However, one of its respected “thought leaders” has told the BMJ that the Healthology programme in which he appears has a lot to do with drug company marketing strategies.

Professor James Miller, a doctor from the Columbia Presbyterian Medical Center in New York, is featured in a Healthology webcast being interviewed about the pros and cons of three drugs for multiple sclerosis (www.healthology.com). The programme is presented by a WNBC medical reporter, who tells the audience the sponsor is a group called “MS Active Support,” but fails to inform them that “MS Active Support” is funded by Biogen, the biotechnology company that manufactures one of the three interferon drugs being discussed. As it happens the Biogen drug emerges favourably from the programme in which Miller appears, although a company spokesperson told the BMJ that it had no influence over the topic or the content.

“All the drug companies are doing it, God knows,” says Miller, who has been a paid speaker for Biogen. “The battling is purely a marketing issue. Companies like Healthology get caught up. Every one of the drug companies has these organisations that front for them.” Soon after The New York Times revelations last week the WNBC reporter ended his contract with Healthology, just as others have reportedly severed ties with WJMK.

“Video news releases”—television versions of press releases—and “advertorials”—newspaper advertising designed to look like editorial articles—have been around for a long time, but Haimowitz's brainchild is really something new, and it is part of a growing entanglement between the pharmaceutical industry and the mainstream media. Apart from the “educational” activities such as sponsored videos, drug company spending on direct-to-consumer (DTC) advertising rose by almost 150% between 1997 and 2001, and drug advertisements now add $3bn a year to media company turnover. For countries without DTC, other forms of financial ties exist, raising serious concerns about conflicts of interest for media organisations and their journalists.

In Australia senior broadcast journalists with major national networks have worked as paid consultants producing materials sponsored by drug companies, at the same time as covering issues and products in which those companies have a direct interest. Senior wire service journalists have taken gifts of international travel to cover medical conferences from companies whose products were showcased at those very same conferences.

Health reporter Melissa Sweet has written of accepting company-funded trips in the past to visit Germany and Scandinavia. “But no more,” she wrote two years ago in these pages. “With compelling evidence to show that close ties with industry can influence doctors' behaviour, there's no reason to expect journalists would be any different” (BMJ 2001;323: 1258).