Swine flu pandemic media with pharma links more likely to talk up risks, promote drugs

During the 2009-2010 swine flu pandemic, the UK spent an estimated £1 billion on pharmaceuticals, including antiviral drugs (neuraminidase inhibitors) and an H1N1 specific vaccine. Pharma made £4.5-6.5 billion out of H1N1 vaccines alone.

Concerns were subsequently raised about the links (competing interests) experts on influential scientific advisory committees, including the WHO's Emergency Committee, had with drug companies.

Researchers retrospectively analysed UK newspaper print coverage of the HIN1 swine flu pandemic, to assess the extent of competing interests among sources quoted on the topic between April and July 2009 -- the period when major decisions were being made about how best to respond to the emerging threat.

Daily, Sunday, tabloid, middle market, and broadsheet publications on both sides of the political spectrum were included, to reflect a range of perspectives and reporting styles. Broadcast media were excluded on the grounds that print media offered more in-depth analysis and more divergent viewpoints.

The final sample of 425 articles was scrutinised for the sources quoted, the assessment of the risk to the population made by each source, and the promotion or rejection of drugs/vaccines.

Competing interests for each named academic quoted were then unearthed, using conflict of interest statements, funding sources detailed on profile pages, Google searches, and funding declarations on all publications in the previous four years.

Grants, honoraria, speakers' fees, consultancies, advisory roles, employment, and directorship/stock ownership were all considered competing interests.

The analysis showed that during the study period, health ministers were the most frequently quoted source (34%) in media articles on swine flu, followed by academics (30%). Sixty one academics were quoted, 18 (30%) of whom had competing interests.

The academics made 74 risk assessments, over half of which (44; 59.5%) were higher than those made by official agencies, such as the Department of Health, in the same article.

Of these, 35 were made by academics with competing interests, meaning that risk assessments from these academics were almost six times as likely to be higher than those from official agencies, compared with risk assessments made by academics without any industry links.

Twenty academics commented specifically on drugs/vaccines in 36 articles (8.5% of the total). Half of them had competing interests -- a higher proportion than the one in three on the WHO's Emergency Committee.

Half of the commentators promoted the use of antiviral drugs and around half (45%) promoted the use of a vaccine. Some 15% promoted both.

Academics promoting the use of antiviral drugs in newspaper articles were eight times more likely to have pharma industry links than those not commenting on their use.

Only three articles out of the 425 mentioned that the quoted academic had a potential competing interest.

The researchers acknowledge that the interviews may have contained more nuanced views than appeared in print, and that journalists may have sought divergent views to balance a story or increase its newsworthiness.

But academics are a trusted and accessible source of comment for journalists and are in a unique and powerful position during emerging public health threats, they say. "Our results provide some evidence that the provision of higher risk assessments and the promotion of [antiviral drugs] are associated with [competing interests] among academics," they write.

"These add to the growing body of literature highlighting the potential influence of the pharmaceutical industry on policy decisions through multiple avenues, including advisory committees, drafting of guidelines, and media commentary," they note. "Undisclosed [competing interests] degrades public confidence in medical research, to the detriment of the whole scientific community," they write, concluding: "Academics should declare, and journalists report, relevant [competing interests] for media interviews."

Commenting on the research, the journal's joint editors, Martin Bobak and Jim Dunn, add: "This paper clearly shows that 'scientific advice' is not necessarily independent and that it is influenced by often undisclosed interests. From an editor's point of view, this is disturbing, because there are limits as to how far journals can go in establishing authors' conflicts of interest."