“Fear and Self-Loathing In Pharma-land”

The PRSA Health Academy Meets in DC

By Jim Cameron, Cameron Communications Inc.


(Washington DC – May 5-6, 2005): Over 200 PR professionals in healthcare began their meeting in Washington in a self-deprecating mood. Billed as “Regaining Public Confidence in the Healthcare Industry”, attendees knew what they were in for. This meeting would be akin to a meeting of nuclear engineers right after Three Mile Island almost had a meltdown.

The morning began with a high-carb feast of danish and bagels, comfort food for the afflicted. Presenter after presenter reminded the attendees that recent public opinion polls ranked Pharma only slightly higher than tobacco companies and oil barons in terms of credibility. Wanting so badly to be loved, the PR folks couldn’t understand what had gone wrong.

Why do Americans think drugs are over-priced? Why don’t they understand the $800 million cost of bringing new drugs to market? Why don’t they appreciate that all Rx drugs have some risk? How is a VNR or SMT different than a press release? Why don’t they love us anymore!!

“We must be transparent”

The word of the day was “transparency”, the current euphemism for “telling the truth”. Keynoter Dr. Bernadine Healey (former director of NIH, The American Red Cross and now a USN&WR columnist) accused Pharma of “opacity” in refusing to reveal its drug pricing policies under the guise of protecting trade secrets. She said in her recent work on an Ohio Medicaid panel she was unable to find the true cost of the top ten Rx drugs in her state. Pharma refused to reveal the pricing.

True, making drugs is expensive. But why do American patients pay most of the cost? “We should spread drug development costs across other developed nations,” she said, singling out the French as a ready target of shifting costs away from US consumers. If they paid more for Rx drugs, Americans wouldn’t have to.

As attendees dined on red meat and humble pie, she said that Pharma should stop pandering to doc’s. (Indigestion seemed imminent as we all reached for our Tums).

Working with Docs

“We need to build an alliance with doctors, not pander to them with pens, free dinners and golf.” A couple of Pharma folks looked in need of the Heimlich maneuver. But her harshest words were for doc’s sitting on review panels considering drugs in which they had a financial self-interest. Case in point, the recent cholesterol recommendations from a panel of docs all of whom, except one, had a financial interest in statins.

But Healey stunned the conference with her pronouncements on counterfeit drugs. “Canadian drugs aren’t dirty,” she said, teasing her column next week in which she promised to detail Pharma’s “dirty little secret”… that 1% of all US drugs are phony. The FDA has no authority to audit the “grey market” that distributes 10% of all Rx drugs in the US, she said. (Author Katherine Eban’s book “Dangerous Doses” also due next week, she says, will “tell all”.)

Healey said that, instead of waiting for the FDA to tell them they must, Pharma should embrace tracking technologies like RFID and get ahead of this counterfeiting crisis.

Asked by this reporter what she thought of the media’s overall coverage of healthcare, Dr. Healey tossed bouquets to her fifth-estate buddies. “I think 98% of it is wonderful! And God… I love those bloggers!”

“I love those bloggers”

In my panel I spoke of journalists’ newest tools… blogs, RSS and Google News… as they search for fresh angles and sources on stories. Most attendees knew nothing of the millions of e-opinions sloshing thru cyberspace waiting for curious reporters to find them. Nor had they thought about patient activists, or even phony bloggers, who can trash a company in anonymity and have their opinions dished up online alongside AP and Reuters clips. Mainstream media may not be dead, but it seems on life support.

In the exhibit area, the VNR production house DS Simon acknowledged that, yes, it is harder to get airtime for VNR’s since it was disclosed that the Federal government had spent $250 million on VNR production aired (willingly, I might note) by stations under the guise of “news”. (Full disclosure: I have narrated VNR’s for many clients. They say I have the ‘perfect face’ for audio work.)

Conference attendees’ tight muscles and sore backs, provoked by the angst-filled morning sessions, were eased at VoxMedica’s exhibit booth with free Swedish massages. (Yes, I had one… but no danish!)

If misery loves company, PR pro’s took consolation in the comments of Dr. Stuart Seides, past-President of the Medical Society of DC. Bemoaning the presence in the doctor’s office of invisible representatives of managed care, second guessing the docs’ every move, Dr. Seides referred to attorneys as “an internal terrorist organization that’s a worse threat to freedom than Al Quida.”

Why are they all out to get us? Are we paranoid or is this all just a bad dream?

Healthcare Ethics: Not An Oxymoron

An afternoon panel on “Healthcare Ethics & Politics” heard more confessions and self-loathings. Edward Allera of DC’s Buchanan Ingersoll PC said Pharma wasn’t being open and honest. “My (Pharma) clients get phase one results that look promising and say ‘We should run with this’, but I have to remind them that they never reported on four other trials that were duds.”

Again, transparency seemed the salve that could cure the credibility rash. Heads nodded as we dined on an afternoon coffee-break of brownies, cookies and coffee and got sugared-up for the final panels of the day.

“We’re not doing enough to explain the risk-benefit ratio to the public,” said Jessica Stollenberg of Wyeth. I asked how that could be done with package inserts in 5 point type that nobody, especially the elderly, could even read.

Playing on the theme of “transparency”; I asked the ethics panel if doctors being used by Pharma as spokespersons should be asked to reveal that they were being paid an honorarium. (Full disclosure: I media train many of those docs for Pharma clients, but always ask them that question in role playing. They always struggle with an answer).

“Reporters know that doc’s are being paid,” said Stollenberg. “I just don’t think the public understands why.” Why, indeed? “We can’t expect a cardiologist who makes a half-million to do an interview for less than $5K,” she added. I noted that when they do CME dinner-talks, docs must disclose their “consulting relationships” and that if financial analysts can be quizzed on CNBC about conflicts of interest, shouldn’t docs expect the same in interviews?

Why don’t they love us? Why are reporters so adversarial and proctological?

According to one seasoned vet, it all comes down to jealousy in our classless society.

Are Reporters Jealous?

As former Wellpoint PR-czar Ken Ferber put it on an earlier panel… reporters don’t make a lot of money. Their companies are being downsized and they’re now expected to do more work for the same, or less, pay. “They can’t write about their (media) company officers’ pay scales, so they (take it out) on us.”

They say an army marches on its stomach. This well-run, thought provoking day of discussions seemed powered by caffeine and adrenaline. But an evening reception at a trendy Potomac-side restaurant saw a mad dash to the two open bars. The food was good and I watched two complete smoked salmon get inhaled by the throngs as Day One drew to a fitting close.

Day Two’s weather matched the mood… cold and cloudy. Gone was the fresh hint of spring. It was back to the winter of our discontent.

Somebody in catering got the message that this was a healthcare conference, so the breakfast carb-fest was augmented with fresh fruit… appropriate fare, given the first panel of the day on the obesity crisis.

The Obesity Crisis

Department of H&HS PR guy Kevin Keane showed off his Ad Council campaign “Small Steps” with some extremely funny PSA’s aimed at getting people off their butts. “There’s no guilt, no attacks on foods and no diets,” he said, noting the campaign is second only to Homeland Security spots in airplay. One wonders which is the bigger threat… Osama or Oreos?

But just as it sounded like the Fed’s were finally talking about maintaining wellness, not just fighting illness, our HHS speaker made a Freudian slip. “When I lose ten pounds I feel a lot better,” said Keane. “Of course, then I put it back on.” Step away from the danish, Kevin!

Next up, the bravest panelist of the day… Terri Capatosto from McDonalds, celebrating its 50th anniversary with some stunning stats: 2.4 million customers (“guests”) a day, 13,000 US restaurants and 1.5 million employees. The average American eats four meals a month at Mickey-D’s, and now they’re eating more than McNuggets and fries.

Spun by McDonalds

Attendees were all offered samples of the newest in healthier fare… the “Fruit and Walnut Salad” with yogurt. Capatosto says it’s very popular with women who enjoy the “fruit buzz” it gives them. That sounded like a drug reference to me, but it was mighty tasty, though I didn’t need the candied walnuts which added 6 grams of carbs to my Atkins-attentive personal diet. (Full disclosure: I’ve dropped 60+ pounds on Atkins in a year and it wasn’t with any help from Ronald!)

With ‘nary a mention of the attack-documentary “Supersize Me” and only passing reference to McDonald’s recent controversial consulting deal with one-time critic, Dr. Dean Ornish (akin to GM hiring Ralph Nader to design a new car), the lady from McDonalds dished up a series of TV spots showing new role models for kids… hyperactive little 4 year olds bouncing off the walls who looked to be candidates for Ritalin as much as poster-kids for getting more exercise.

We’d been spun, and we loved it. Rather than speak of the PR challenge of overcoming years of negative PR, Capatosto had us all munching on apple slices and thinking that Ronald McDonald was looking a little less paunchy these days. I was stunned, but enjoying my “fruit buzz”.

“Motivational speaker” Mike Meyerheim was next up, sharing his story of a 14 month journey from 412 pounds to 208 as highlighted with his 15 minutes of fame on Dr. Phil. We were stunned. Who let this guy in? Here was a real person, not a flack or government weasel. And he wasn’t selling us anything. His was a great story, without a catch, and that was refreshing indeed.

Softball question of the day came from somebody who asked Capatosto; “Do you sometimes feel McDonalds is a scapegoat for Americans’ bad eating habits?” And 50 points to her for not starting her answer with “I’m glad you asked that…”

The session adjourned and we headed for the coffee break, sheepishly gobbling the muffins and fruit. No time for exercise, though.

Picking Up The Pieces

The next session was excellent… “Conversion After a Crisis”. Conversion? Religious? AC to DC? No, reputation repair. Picking up the pieces.

Larry Kamer from Manning Selvage & Lee was scary-smart, noting that the Chinese symbol for the word crisis was two thoughts: risk on top of opportunity. Favorite quote: “There are three words that, when they’re all together, really frighten me: media training doctors.” Tell me about it!

Chris Thomas of The Intrepid Group told of his work handing the family of Jessica Smart after her abduction. “Working with the media in a crisis is a lot like obedience-training a dog. You need touch, tone and training.” His seven-point plan was brilliant. Ask him for his slides.

David Henry from TeleNoticias rounded out the panel with some sage advice on the care and feeding of the broadcast media in a crisis: have B roll ready and get it blessed in advance by your lawyers in case it gets subpoenaed afterwards.

Good information. No dumb questions. And no self-loathing. What happened? Could we be ending on an up-note? Not quite.

The Media Talks Back

The luncheon panel had us back on the steady diet of self-loathing as the actual members of the media took center stage. Had their ears been burning from all we’d said about them in day one? Apparently not. While we dined on chicken, they’d obviously had their red meat as, tanked up on adrenaline, they literally bit the hand that had just fed them.

“The Pharma industry is its own worst enemy,” said John Carey of Business Week (a recipient of three different degrees in science, according to his bio). “The industry’s bad press is well-deserved, whether its generic conversion shenanigans, hyping off-label use or pricing.”

Industry cheerleader Rex Rhein from “Scrip” said his publication was mostly read by Pharma executives. I guess it’s sort of like prescription drugs. “Anybody can buy Scrip, but only Pharma exec’s can afford it.” Rex made sure we all got a free copy of the UK-based trade. I noted that annual subscriptions were $1785. I guess we won’t be reading much of Rex’s work after today.

Trying to lighten the tone of the panel, Novartis moderator Bob Laverty showed a “Simpsons” clip which poked fun at drug costs. If the truth hurts, satire stings, but we all had a good chuckle.

Not fair, cried Marilyn Serafin of The National Journal. Did the “Simpsons” satirize drug costs because of media coverage, or did the media pick up on the issue because the cartoon writers shoved it in their face? “Does the media reflect society or influence it,” she asked.

Hello!?! Isn’t the operative issue here that Rx drugs are expensive and we can’t explain why?

Unanswered Questions

Reflecting on the two day conference, I realize that question was often asked, but never answered. There were plenty of senior Pharma exec’s in attendance and loads of their PR counselors, but none of them tackled the question every American wants answered. It was as if we should all know the answer and didn’t need to ask. Or, maybe it’s because we’re afraid to ask because we know the answer. So much for transparency.

As we quaffed our umpteenth cups of Starbucks high-test, Washington Post writer Fran Kritz told us she loves her job, seeing her role really as one of being an informer. “My husband asks why I don’t go work for a Pharma company. I like being a reporter,” she said. “But I wouldn’t mind that (Pharma) pay scale.”

Gosh golly gee. Ken Ferber was right after all. These pesky reporters really are jealous. Imagine if they knew about the honoraria the docs they interview were getting. (Full disclosure: like me, the reporters all got thank-you gifts for appearing on the panel… Waterman ballpoint pens with a PRSA logo.)

Alas, I had to bail before the final sessions of the afternoon, so I didn’t get to hear the panel defending use of celebrity spokespeople or the academic who was going to address rebuilding employee morale. My morale was long gone. I was drained. I missed the end-of-day raffle for the gift certificates to SpaFinder and GNC.

This report is by no means comprehensive as I missed more panels than I attended, but I have tried to capture the mood and color of the meeting. All quotes are as accurate as possible.
I met some interesting people. The panels were good, though over-packed with speakers and, often, long-winded moderators. The topics were timely. But God it feels good that it’s over. Any more self-criticism and we’d all need therapy, not just Swedish massage.

JIM CAMERON
Cameron Communications Inc.
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