Concerns over pharma industry sponsorship of health journalism in Australia

The pharmaceutical industry has scored a significant marketing coup in Australia, sponsoring a major health journalism series in the News Limited broadsheet newspaper, The Australian.

But the deal has raised concerns among some journalism leaders, researchers and health professionals.

The series, titled Health of the Nation, featured articles by senior health journalists and policy experts. It included a roundtable meeting of policy experts, video footage, and a survey of the general public about their views and experiences of healthcare.

The series' banner [left] included a tagline, "supported by the Australian medicines industry." While this could be seen as open disclosure, it equally looks like effective corporate branding.

The series culminated in a glossy colour magazine, published on October 22, which featured a selection of the articles, together with advertorials and advertisements for the pharmaceutical industry.

As part of the sponsorship deal, the industry body, Medicines Australia, received 20,000 copies of the "Health of the Nation" magazine to distribute among member companies. It also gave several hundred copies to a consumer health group, the Consumers Health Forum, which had contributed to the series.

The chief executive of Medicines Australia, Dr. Brendan Shaw, promoted the series on an industry blog in July by saying "it should be a fascinating study on what the Australian public thinks about healthcare and our health system."

According to Medicines Australia, the sponsorship arrangement arose out of meetings between its advertising agency and News Limited's promotions and advertising teams, which "recognised common interests."

"News was interested in creating a Health of the Nation series and vehicle to stimulate consideration, discussion and debate about health issues in Australia with its readership," said a Medicines Australia statement. "Medicines Australia was interested in a communication platform to increase awareness of The Australian Medicines Industry as 'supporting Australia's health' and get Australians thinking about the industry."

Medicines Australia, which also sponsors health journalism awards run by the National Press Club of Australia, would not reveal the value of the deal with The Australian, saying it was "commercial in confidence."

The Australian's editor, Clive Mathieson, and its health editor Adam Cresswell both insist that the newspaper's editorial independence was maintained.

"There is no way The Australian would have agreed to any commercial relationship that compromised its editorial independence and integrity," Mathieson told me when I was researching a news story for BMJ (formerly called British Medical Journal) about the deal. "I would defy anyone to think there was any bias in any of that coverage, anything that was overtly favourable to Medicines Australia or the pharma industry."

Cresswell also stressed the independence of the articles, but acknowledged that the arrangement was "unusual." He said: " I fully accept there are dangers in such arrangements if not handled properly. However, I would argue we did handle them properly."

But many observers, myself included, believe that focusing on the content of the series is a distraction from the more important issues at stake. Relations between the pharmaceutical industry and researchers, clinicians and institutions are an important ongoing subject of investigation. It is difficult for media organisations and journalists to scrutinise such relationships if they are themselves entering into special relationships with the pharmaceutical industry – whether by accepting sponsorship for editorial, funded journalism prizes, or travel to conferences.

When I wrote about the arrangement for the BMJ last month, I quoted researchers and journalism leaders who raised concerns about the arrangement, including Gary Schwitzer, publisher of HealthNewsReview.org, and Charles Ornstein, president of the Association of Health Care Journalists and a senior reporter at ProPublica.

Ornstein noted that traditionally, "reporters didn't know which advertisers would appear alongside their stories, and advertising sales reps didn't know what stories would appear in the paper. More to the point, whenever ideas for news coverage are generated from the marketing or advertising departments - not from the newsroom - one must question whether it was simply because an advertiser desired it."

Dr. Wendy Lipworth, a researcher at the University of New South Wales who is studying corporate influences upon media reporting of health, said she was worried "not so much about the content of reports in this particular series (which I am sure will be very carefully balanced if they discuss industry issues), but rather about the effect of the industry support for this series on subsequent reporting of industry-related issues.

"I also wonder about the effect of having a declaration of funding on the same page as an advertisement. While such declarations are usually seen as distancing mechanisms, I wonder whether the combination would give some readers the impression that the newspaper endorses the advertisement and industry more generally."

It is worth noting that the Australian medical press (which are largely funded by pharma advertising) do not generally link print news editorial to specific advertisers.

However, it is also worth noting that media traditions of not linking specific advertisements to editorial apply very much to newspapers. Online publishing is breaking down some of the demarcation between editorial and advertising.

Not all comments were critical of the deal. Carol Bennett, CEO of the Consumers Health Forum, who attended the newspaper's roundtable meeting, said she believed editorial content had not been influenced by the sponsorship.

The series had provided a welcome opportunity to have substantial media space devoted to complex health policy issues, she said, and the sponsorship had been transparently declared. "Sometimes you have to weigh up the pros and cons; in this instance it let us get out messages that wouldn't otherwise be out there in the public domain," she said.

After the BMJ story, the issue generated a series of posts and comments at Croakey, a public health blog that I moderate. Dr. Tim Woodruff, vice president of the Doctors Reform Society, wrote that one concern about the arrangement was that it improved the image of Medicines Australia at a time when the industry is contributing to higher prices of drugs in Australia to the detriment of some patients. He wrote: "Thus, if the arrangement with the newspaper improves the image of Medicines Australia, the discussion in the wider community and in the corridors of power may be influenced not to look so negatively on the ways in which Medicines Australia is acting to maximise its profits."

So far as I am aware, the arrangement has not prompted wider media debate, beyond the related coverage at Crikey and its health blog Croakey, and the BMJ.

We all know these are difficult times for media organisations. Advertisers are expecting more and more, and it becomes ever more difficult to fund quality journalism.

I am entirely sympathetic to the notion that we need to find new ways of funding journalism, especially if it is to investigate issues that don't generally get the airing they deserve – like health policy. I support calls by an Australian journalism academic, Bill Birnbauer (formerly an investigative health journalist and currently a board member of the Public Interest Journalism Foundation), for tax breaks to support not-for-profit journalism. Birnbauer has argued for this in a submission to an inquiry now underway in Australia into media regulation.

But efforts to find new ways of funding worthwhile journalism need to be driven by a concern for the public interest, rather than an industry's marketing agenda.

Journalism was not the winner in the deal between Medicines Australia and The Australian.

The value of that glossy magazine supplement to Medicines Australia – thanks to its close association therein with leading health journalists and policy experts – far exceeds the hundreds of thousands of dollars the deal must have cost the industry. 

Declaration: Melissa Sweet is involved with an Australian study investigating relationships between the media and health-related industries. She is a freelance health journalist, moderator of Crikey's health blog Croakey, and Secretary of the Public Interest Journalism Foundation.