Medicines and the media: news reports of medicines recommended for government reimbursement in Australia

Our plain-English summary of Medicines and the media: news reports of medicines recommended for government reimbursement in Australia, by J. Robertson, E.J. Walkom, M.D. Bevan, et al (BMC Public Health, 2013).

The study

• Authors: J. Robertson, E.J. Walkom, M.D. Bevan, D.A. Newby
• Journal: BMC Public Health
• Published: 2013;13:489
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Previous analyses of the listings of trastuzumab on the Australian Pharmaceutical Benefits Scheme (PBS) and HPV vaccine on the National Immunisation Program (NIP) suggest a media influence on policy makers. We examined the timing and content of Australian newspaper reports of medicines in relation to Pharmaceutical Benefits Advisory Committee (PBAC) decisions.

Methods: We identified newspaper reports (2005-2008) of medicines recommended for PBS listing in 2006-2007, analysing the content for mentions of the medicine, PBS and medicine costs to the patient and the government and counting the numbers of articles published in the six months before, the month of, and the six months after the relevant PBAC meeting. Case studies examined reporting for infliximab for Crohn's Disease, pemetrexed for mesothelioma, and ADHD (Attention Deficit Hyperactivity Disorder) medicines atomoxetine and methylphenidate.

Results: Of 79 eligible medicines, 62 had news reports. Most often reported were HPV vaccine (1230 stories), trastuzumab (410), pemetrexed (83), botulinum toxin (71), lapatinib (65), methylphenidate (57), atomoxetine (54), infliximab (49), rotavirus vaccine (45). Eighteen medicines had ≥20 news reports (total 2350 stories); nine of these cost more than AU$10,000 per course or year of treatment. For these 18 medicines, 31% of stories appeared in the six months prior to the PBAC meeting, 14% in the meeting month and 33% in the six months post-meeting. 38% of the stories had ≥3 medicine mentions, 37% referred to the PBS, 24% to cost to the patient, and 9% cost to Government.There was active patient lobby group campaigning in support of listing of infliximab and pemetrexed; the stories for ADHD were often more negative, referring to the dangers of the medicines and sometimes questioning the appropriateness of treatment and public subsidy. There was little discussion of the PBAC's evidence-based decision-making processes.

Conclusions: While there was no general trend to increased news reporting associated with PBAC meetings, some drugs did attract media attention. With more new and expensive drugs, decisions on public funding will become increasingly difficult. The media have an important role in enhancing public understanding of the issues around resource allocation. Specialist journalists, guidelines and checklists may help reporting.

In plain English

This study looked at how Australian newspapers covered medicines that a government advisory committee, the Pharmaceutical Benefits Advisory Committee (PBAC), recommended for public subsidy in 2006 and 2007. It was not a study of asbestos exposure. Its link to asbestos is one case study of pemetrexed, a drug for mesothelioma. The authors searched a news database covering July 2005 to June 2008, then counted and coded the stories. Of 79 recommended medicines, 62 appeared in 2664 stories. For the 18 most-reported medicines, 31% of stories ran in the six months before the relevant PBAC meeting, 14% in the meeting month and 33% in the six months after. Pemetrexed had 83 stories, 39 of them in the meeting month. Before its November 2007 recommendation, mesothelioma patients were described as innocent victims, and campaigner Bernie Banton delivered a 17,000-signature petition. The authors found only one article that gave any detail on the PBAC decision. They concluded there was no general rise in reporting around PBAC meetings, though some drugs drew attention. They noted the study used one database and left out online and television news.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Content analysis of newspaper articles, using descriptive statistics, plus three qualitative case studies (infliximab, pemetrexed, and the ADHD medicines atomoxetine and methylphenidate)
• Who was studied: Australian newspaper articles (more than 40 newspapers in the ANZ Proquest Newsstand database), July 2005 to June 2008, about 79 medicines that received a positive PBAC recommendation for listing in 2006 (42 medicines) and 2007 (37 medicines)
• Exposure: Not an asbestos exposure study. What was studied was newspaper coverage of medicines, including pemetrexed for mesothelioma, described as a disease resulting from exposure to asbestos.
• Main results:
  • Of 79 eligible medicines, 17 had no news reports; 2664 stories related to the other 62 medicines.
  • For the 18 medicines with 20 or more reports (2350 stories), 31% of reports appeared in the 6 months before the PBAC meeting, 14% in the meeting month and 33% in the 6 months after the positive recommendation.
  • For those 18 medicines, 38% of stories mentioned the medicine 3 or more times, 37% referred to the PBS, 24% to personal cost to the patient and 9% to overall cost to Government.
  • Pemetrexed (mesothelioma) had 83 stories, the third most of any medicine: 20 in the 6 months before, 39 in the PBAC meeting month and 16 in the 6 months after.
  • Of the 83 pemetrexed stories, 20% had 3 or more drug mentions, 99% mentioned government subsidy, 45% personal cost and 7% government cost.
  • Before the November 2007 recommendation for pemetrexed, patients were described as innocent victims, and there was active lobbying, including a 17,000-signature petition from Bernie Banton.
  • The authors found only one article giving any detail on the PBAC decision for pemetrexed, and little discussion of its potential cost implications.
  • Coverage of the ADHD medicines often focused on the dangers of the drugs.
• The authors' conclusion: The authors concluded that they found no evidence of more intense newspaper reporting close to PBAC meetings, although some specific drugs drew heightened media activity, and that media prominence is a poor basis for decision-making.
• Limitations the authors state:
  • The study used a single news database, which does not include all Australian newspapers or any online or television news.
  • Syndicated stories, and stories used in more than one edition, were counted as separate stories.
  • Few classification frameworks were available, and counting drug mentions was not always a good guide to an article's focus.

Topics

Medical terms in this study, explained in our Lexicon: Trastuzumab, Pemetrexed (Alimta), Mesothelioma.

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