The Dangers of Media Misreporting Medicines

It's a tricky balance. It's a good thing that the media report on medicines. But it can be a bad thing when the media get it wrong.

The media is alleged to have got it wrong last week in reporting a study in the Annals of Internal Medicine. The article, entitled "Economic Savings Versus Health Losses: the Cost-effectiveness of Generic Antiretroviral Therapy in the United States", was published on January 15, reporting research by Rochelle Walensky of Massachusetts General Hospital and others. The following day, BBC News covered the article in the health section of its online service, in a story entitled “Study Questions Generic HIV Drug Use.”

Two days later, the BBC article was denounced by the World Health Organization in a follow up piece that appeared in the Annals of Internal Medicine. The WHO piece, entitled “Generic Antiretroviral Therapy is Safe and Effective”, claimed that the BBC article had seriously misinterpreted the Walensky research. The BBC piece had, said WHO, "unfortunately" presented the findings as indicative of the need to make an ethical trade-off between cost savings and efficacy, when the research was merely a modelling study describing a mathematical simulation of HIV disease. "Such an interpretation is misleading and not supported by the extensive global evidence of the efficacy of quality-assured generic antiretroviral therapy,” insisted the WHO.

The incident exposes some interesting issues. One is the role that the media can or should play in disseminating research. Annals of Internal Medicine is not read by the general public. The BBC News website is. In principle it is obviously a good thing that complex scientific information is made available to a wider public. This of course often requires some degree of rewriting, to make the complexities comprehensible to non-specialists. And that rewriting always carries some risk of misinterpretation. So there is a heavy duty on the media to ensure accuracy in that rewriting.

Another is how specialists should react when the media misinterpret scientific findings. In this case, the response was swift from the WHO. Within 48 hours of the BBC piece appearing, the Director of the HIV/AIDS Department and the Director of the Department of Essential Medicines and Health Products had their criticism of it online in the Annals of Internal Medicine. That was certainly fast. But it was obviously not enough, because insofar as there was a risk of public misunderstanding resulting from the BBC piece, very few of those misled citizens would be reading Annals. So six days later the WHO sent out a general press release to draw attention to its criticism of the BBC piece.

The nature of the reaction by specialists is as important as the speed. The press release focuses on the suggestion that the BBC piece was misleading. But in support, it attaches the WHO article from Annals - and this, to the non-specialist, appears at first glance to back up the assertion in the BBC piece: "The authors of the study caution that this may require a trade-off between drug efficacy and cost savings", says the WHO article. A closer reading makes clear that the WHO take on the Walensky piece is more nuanced. But unfortunately (to borrow a term from the WHO), the first impression is often what counts in the non-specialist world.

One more reflection. The BBC piece itself is not (despite the impression given by the WHO) a black-turned-to white perversion of the original research. It uses its interpretation (or perhaps misinterpretation - it is not for this columnist to judge) as the lead-in to a broader discussion of generic HIV treatment, featuring plenty of distinct views from HIV organisations - and even a quote from Dr Walenksy herself. Which is very much the role of the media. I, of course, have to declare an interest, in that I have earned my living for many years by writing for non-specialists about specialist subjects. I would not wish to minimise the importance of fastidious accuracy, and more particularly in matters of great significance, but I would not wish, either, to inhibit intelligent discussion among non-specialists of specialist topics, merely because a risk exists of misinterpretation.