Viagra vs. Synthroid: two big drug stories show big differences in reporting priorities

Health 28-3-2018 HealthNewsReview 1765
viagra synthroid clickbait

I came across these two drug stories over my morning coffee yesterday.

One: This week marks the 20th anniversary of the FDA approval of Viagra.

As anniversary reporting goes that’s arguably newsworthy, and a nice round number, so this flood of coverage isn’t really surprising.

Two: Last week, a new report listed the most prescribed drugs in the US by state and the thyroid replacement hormone, levothyroxine, was #1 in about half the states.

As listicle reporting goes that’s also considered newsworthy, and relevant in a country that fills more than 4 billion prescriptions a year, so this modest coverage isn’t really surprising either.

What may surprise you is that the point I want to make doesn’t have so much to do with the quantity of coverage but more to do with quality. Perhaps even more to do with what news organizations deem ‘clickable’ and what we as readers find alluring.

Why the flood of coverage?

Viagra — like Prozac used to be — is a rock star in the prescription drug world. It’s found its way into novels, movies, urban myths, hospital formularies (yes), late night TV, race dogs (not kidding), CIA negotiations (with Afghan chieftains), and (of course) comedy routines.

And that’s just the short list.

Bob Dole, Viagra spokesman, 1998

It’s made manufacturer Pfizer over $17 billion as of a few months ago. And the staggering statistics go on and on and on and so did the stories this week. But to what end?

A lot of the coverage, like USA Today’s, focused on these staggering statistics ; the Washington Post focused on the history of the drug; Fortune, not surprisingly, highlighted it’s financial success; Huffington Post posited Viagra has irrevocably changed the relationship between men and women, and The Atlantic and Time argued it’s revolutionized sex.

Let’s be clear: the history, statistics, and impact on sexuality of Viagra do hold some allure. But does it really justify nearly every major news outlet across the country giving an “FDA approval anniversary” this much ink and airtime? Some of the coverage was good, but plenty of it was vapid and left me asking “what’s the point here?”

It’s mostly a lifestyle drug. It’s titillating to take and titillating to write about. It’s the drug from the company that medicalized ‘erectile dysfunction’ and gave us ads that somehow managed not to be about what they were about.

Ask yourself: why does the 20th anniversary of this drug warrant such widespread coverage? What does it say about our news rooms? Our culture of pharmacy? Us?

The dividends of digging deeper

Here’s how last week’s report (from GoodRx, an online company that tracks prescription drug prices) on the most commonly prescribed drugs (by state) came to my attention.

It was a great piece of writing by Markian Hawryluk of the Bend Bulletin in central Oregon. Instead of just saying, “Isn’t it weird that the most prescribed drug in Oregon is levothyroxine?” (which is just what many other reporters did in localizing the report to their state), Hawryluk takes a different tack. He asks a simple question: Why are so many people on levothyroxine (Synthroid)?

From Kaiser Health News (click to enlarge)

In answering that question his excellent reporting hones in on the equivocal ‘gray area’ of diagnosing diminished thyroid function (“hypothyroidism”) and the mounting evidence that the condition is most likely overdiagnosed and overtreated — causing more harm than good for many of the people prescribed levothyroxine. He takes an interesting statistic and shows how it may be evidence of dysfunction within our health care system. 

He finds several sources, cites several well-designed studies, outlines the recommendations of the U.S. Preventive Services Task Force regarding thyroid screening, and provides alternative explanations for why we may be seeing more hypothyroidism (hence, the high prescription rates for thyroid replacement hormones).

It’s great reporting with a focus on informative and timely content that can really help people.

There was some other reporting that deserves mention. Jenny Gold of Kaiser Health News quoted Geoffrey Joyce, director of health policy at the Schaeffer Center at the University of Southern California, who pointed out this important limitation of the GoodRx report:

The data represented in the map could give a misleading picture of prescription drug patterns. It looks at individual drug products instead of larger classes of drugs used to treat a given medical issue. Overall, when similar types of drugs are grouped together the most common prescriptions are for drugs to treat high blood pressure, pain and mental health issues, according to recent data from IQVIA, a health data company.

In the writing of Hawryluk and Gold we see two important principles of solid reporting: ask (and try to answer) a fundamental question … and … search for limitations that your readers should be aware of.

A fundamental question and some limitations

These stories raised a fundamental question: although both drugs are widely prescribed, and each had a timely hook to build a current story around, why were they covered so differently?

Which brings up some limitations: let’s face it, these two drugs and the conditions they treat aren’t comparable. They’re apples and oranges. It’s impossible for me to know, or claim, that some stories are written to generate clicks and others are written purely for information. I can’t pretend to know the motivations, time constraints, and editorial choices involved.

But that’s not really my point. The way in which these stories were handled touches on a larger trend I find disturbing. Shallow reporting on healthcare topics that are deemed popular seems to be on the rise. And in-depth reporting on issues that truly impact the health of many people strikes me as in decline. Why this is happening is complicated enough to warrant several books. Although it may be innocuous enough on the sports or fashion page, it’s potentially harmful in healthcare reporting.

Viagra is not benign. None of the reporting on this 20th anniversary of Viagra that I came across brought this up. Instead, the general tone seemed to lean toward something akin to a hall of fame induction.

In contrast, the examples of in-depth reporting on the thyroid replacement story are encouraging. They educate and they engage. Let’s support more writing like that.

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