According to the Washington Times,1 WebMD, the second most visited health site on the World Wide Web, has received a $4.8 million government contract to educate doctors about the ins and outs of the Affordable Care Act, colloquially dubbed “Obamacare.”
A similar contract for the public portal to educate consumers might also be in the works. However, the lack of transparency and disclosure of the contract has raised questions about potential conflicts of interest.
WebMD has defended against such allegations, saying that the government contract does not affect the company’s news operation, which is free to report what it wants about the health care plan. Still, as stated in the featured article:
“[F]ew if any news outlets earn millions of dollars in training fees from the government on topics they cover, putting WebMD in a unique spot in the media landscape as it navigates not only potential conflicts but also the appearance of conflicts.”
Senator Chuck Grassley (R-IA) has criticized the lack of transparency, telling theWashington Post:2
“Disclosure and transparency would be a good practice for any recipient of federal funding to promote the administration’s health care plan.
Even if certain content is not produced with federal funding, but the same company takes federal government money to produce other materials, consumers would be better-informed by knowing the financial relationships.”
WebMD Charged with Educating Your Doctor on the Plan
According to the featured article,3 the contract includes training services aimed at physicians using the private portal, in the form of “lectures, articles, podcasts and ‘expert viewpoints’ in audio, video, or writing, among other presentations.” Doctors can also receive continuing education credits simply for watching the videos.
These services don’t come cheap. According to the Washington Post, a four- minute long video featuring the viewpoint of a medical expert can cost as much as $68,916 under the contract.
And an “exclusively sponsored” five- to eight-question quiz “to convey key sponsor messages” will cost the US government in excess of $140,000. That said, my criticism of this hidden association between the US government and WebMD does not revolve around their service fees.
The real problem is that WebMD has positioned itself as a primary source of independent and science-backed health information yet is financially dependent on pharmaceutical companies, and now the US government, which is trying to promote a widely contested and unpopular health care plan.
Not only that, but WebMD has in fact been caught red-handed promoting dangerous drug solutions on behalf of their sponsors to people who really don’tneed such treatment—cementing the notion that WebMD is beholden to its sponsors, even at the expense of the safety and well-being of its readers.
Drug Promotion Presented as a Health Screen…
You may recall that three years ago, WebMD was found to have created a depression screening test in which 100 percent of quiz-takers ended up having a “high likelihood of major depression,” and being asked to talk to their doctor about available treatment.4, 5 The test was sponsored by drug giant Eli Lilly, the maker of Cymbalta, and it’s quite telling that no one is found mentally healthy when Eli Lilly foots the bill…
The quiz was really nothing but direct-to-consumer advertising masquerading as a valid health screen. This is perhaps the most hazardous kind of drug advertising there is, as you don’t even realize they’re trying to sell you something. Seeing an advertisement on TV or in a magazine is one thing—you can recognize that as marketing.
But a health screening test on a well-respected health site? Most would fail to consider that such a test might be rigged to turn you into a consumer. It would probably have been more appropriate to present the test with a disclaimer stating: “For entertainment and time-wasting purposes only.”
That mental health screen debacle sounds awfully similar to the quizzes WebMD has now been contracted to produce under this government contract, “to convey key sponsor messages.” What might these sponsored messages be? In all likelihood, they will be related to the promotion of key drugs, such as cholesterol-lowering statins, now that the statin treatment guidelines have been updated to apply to twice the number of patients as previous guidelines.
Key for Successful Propaganda—The Illusion of Independent Corroboration
The drug industry has deep pockets, so it’s no surprise that their adverts would be splashed all over the WebMD website. Prescription drugs for every imaginable problem are listed on virtually every WebMD page, along with plenty of health-harming processed foods and snacks.
The revenue WebMD generates from advertising is considerable. According to a recent WebMD press release,6 the revenue from public portal advertising and sponsorship for the months of July through September, 2013 alone was $109.6 million, compared to $97.6 million for the corresponding quarter in 2012. That pencils out to nearly half a billion a year in ads from the drug companies.
WebMD is a great example of the brilliant marketing the drug companies are doing. They seek to provide you with the illusion of an independent objective third party that just so happens to confirm their solution is the best choice for your health issues. But when you draw back the curtain, you find it’s really the drug companies themselves that are crafting the message—not an independent entity.
It might be worth noting that WebMD is also partnered with the US FDA (Food and Drug Administration). This virtually assures that you will not learn about any alternatives besides those approved by the FDA for your condition, and further strengthens the promotion of sponsored drugs. By default, you will be kept in the dark about the strategies that can make a real and lasting difference.
The lack of independence among promoters and distributors of health information has become of tremendous concern. Due to a dramatic rise in scientific fraud, which is particularly prevalent in the medical literature, it’s more important than ever to be able to gain access to the full set of data before making or taking a recommendation. Not only are industry studies 400 percent more likely to show positive outcomes, negative findings are never published, and raw data is rarely publicly available.
The sad fact is that before we can regain trust in the scientific method, science must be forthcoming with ALL the data. Every clinical trial should be registered before it begins, and all results and raw data should be provided at the conclusion. At present, they’re not… as a result industry sponsored studies have a 400% increase in positive outcomes vs. independent studies, and on top of that the negative studies are never published at all.
Bias Pervades Scientific Reporting
The reality of biased reporting on science was recently highlighted yet again in a study7, 8 authored by John Ioannidis and colleagues at Stanford University. Ioannidis is one of the world’s most important experts on the credibility of medical research. He and his team of researchers have repeatedly shown that many of the conclusions biomedical researchers arrive at in their published studies are exaggerated or flat-out wrong.
Here, they did a meta-analysis9 of 160 other, previously published meta-analyses of animal studies for treatments of a variety of neurological disorders. This analysis ended up covering no less than 1,000 separate animal studies. As reported by Medical News Today:
“The authors’ ‘meta-analysis of meta-analyses’ used the most precise study in each meta-analysis as an estimate of the true effect size of a particular treatment. It then asked whether the expected number of studies had statistically significant conclusions.
Alarmingly, the authors found that more than twice as many studies as expected appeared to reach statistical significance. The authors suggest that rather than reflecting willful fraud on the part of the scientists who conduct the original studies, this ‘excess significance bias’ comes from two main sources.
One is that scientists conducting an animal study tend to choose the method of data analysis that appears to give them the ‘better’ result. The second arises because scientists usually want to publish in higher profile journals; such journals tend to strongly prefer studies with positive, rather than negative, results. Many studies with negative results are not even submitted for publication or, if submitted, either cannot get published or are published belatedly in low-visibility journals, reducing their chances of inclusion in a meta-analysis.”[Emphasis mine]
Changes Are Urgently Needed to Protect Value of Medical Science
Ioannidis’ team speculate that, as a result of these kinds of biased animal studies being published and used as grounds for further research, inappropriate treatments have probably made it into human trials where, of course, the stakes are much higher. But no matter what type of research you’re talking about, scientific integrity and complete uncensored reporting of results matter dearly. As stated in a related editorial in PLOS Medicine:10
“As early as 1990, Iain Chalmers, one of the founders of the Cochrane Collaboration, stated that, ‘Failure to publish an adequate account of a well-designed clinical trial is a form of scientific misconduct that can lead those caring for patients to make inappropriate treatment decisions.’”
Ultimately, when a researcher skews the results to fit a preconceived notion, whether it’s done for prestige or to please funders, consciously or unconsciously, it can eventually affect tens of thousands of patients. As reported by Medical News Today:11
“Adriane Fugh-Berman MD charges that basic science, not just clinical trials, is plagued by financial conflicts of interest. Fugh-Berman identifies evidence showing that industry-funded studies on animals and cell cultures can be as biased as industry-funded clinical trials, and can distort data on medical treatments.12”
To remedy this dismal situation and get medical science back on the right track, Ioannidis’ team makes several suggestions, including:
- Requiring animal studies to adhere to strict guidelines for study design and analysis
- Pre-registering animal trials in the same manner as human trials, in order to ensure publication of results regardless whether it’s positive or negative
- Making methodological details and raw data available in order to allow other scientists to verify the conclusions drawn
Another team of researchers in the Netherlands have drawn similar conclusions. In their essay, published in the journal PLOS Medicine,13 they too recommend study registration and data sharing to improve research quality and conduct. They also argue for the creation of a transparent system in which animal studies are routinely and systematically reviewed and replicated.
Estimates Show $1 Trillion Will Be Spent on Drugs Next Year
A staggering statistic can be found in a new report from the IMS Institute for Healthcare Informatics.14 According to this report, global expenditure for prescription drugs is estimated to hit $1 trillion next year, and as high as $1.2 trillion in 2017. The main driver of increased drug sales is increased access to medical care across the world. In the US, the Affordable Care Act will likely lead to major spending increases, considering the fact that drugs are prescribed for virtually any ailment or complaint you might see a doctor for. As reported in Time Magazine:15
“[I]n a best case scenario of nearly complete enrollment [in the Affordable Care Act], increased demand from more insured people will push up prescriptions. Given the large pool of anticipated new enrollees, however, even if signups are lackluster, Michael Kleinrock, research director for the IMS Institute for Healthcare Informatics says, “We are still [going to] hit $1 trillion in 2014.”
Remember, You Can Take Control of Your Health
It’s important to understand that our current medical system has been masterfully orchestrated by the drug companies to create a system that gives the perception of science when really it is a heavily manipulated process designed to manipulate and deceive you into using expensive and potentially toxic drugs that benefit the drug companies more than it benefits your health.
Across the board, drugmakers do an excellent job of publicizing the findings they want you to know, while keeping studies that don’t support their product hidden from you and the rest of the world.
Also, I’m sure by now many of you can follow the dots and draw your own conclusions with circular maps and arrows marking the many conflicts of interest that exist between this unholy alliance of so-called independent health advisors, pharmaceutical companies, processed food companies, and the regulatory agency, the FDA. Folks, it’s time take control of your health, and that includes being able to discern real health advice from shadow marketing machines and propaganda that serves no one but the very industries responsible for much of the ill health in the first place.
It’s important to realize that all research is NOT published. And it should come as no surprise that drug studies funded by a pharmaceutical company that reaches a negative conclusion will rarely ever see the light of day… And with so much data missing in action, what does the claim “scientifically proven” really amount to? It certainly cannot be construed as a guarantee of safety or effectiveness.
Likewise, if an alternative treatment has not been published in a medical journal, it does not mean it is unsafe or ineffective. There’s a lot to be said for the tried-and-true remedies of old, even if they’ve not been rigorously studied by modern researcher. I recommend using all the resources available to you, including your own sense of common sense and reason, true experts’ advice and other’s experiences, to determine what medical treatment or advice will be best for you in any given situation.