At the end of last year, the Milwaukee Journal Sentinel’s John Fauber completed the sixth and final installment of an 18-month-long series dissecting the US Food and Drug Administration’s approval process for drugs. The stories—thoroughly reported like so much of Fauber’s work— amount to a damning indictment of how the FDA conducts business, sometimes putting the health of the public at risk. The series is also, notably, the fruit of an ongoing partnership with MedPage Today, a New York-based trade publication aimed at doctors and healthcare professionals. Since 2009, the paper and the trade pub have been teaming up to examine pharmaceutical marketing, conflicts of interest in medicine, inappropriate treatment, and, for this most recent series, the shortcomings in the drug approval process. The overarching themes of their work are the influence of money and other non-scientific forces on the practice of medicine.
How did a New York-based trade outlet offering a mix of news and continuing education programs for physicians come to partner with a Wisconsin newspaper on deep-dive investigative work? For one, Fauber and MedPage Today editor-in-chief Peggy Peck had crossed paths professionally over the years and were familiar with each other’s work. “[I] can’t underestimate the role necessity played,” says Peck, who approached the paper to propose the partership. “Our need was a way to develop an investigative unit. The Journal Sentinel and John especially needed a way to make his continuing role as an investigative reporter in medicine a good deal economically.” Peck notes that MedPage Today pays half of Fauber’s salary, frequently underwrites his reporting travel expenses, and provides help with database analysis, video, and access to some subscription data services—not to mention additional reporting heft (reporters Coulter Jones and Kristina Fiore have frequently shared bylines with Fauber). Stories—about 80, including sidebars, over the course of the partnership so far, by Peck’s count—are published similtaneously at both sites, though MedPage tags the work “Slippery Slope” and the Journal Sentinel has used the tagline “Side Effects” and, more recently, “Risk/Reward.”
“Pretty unique,” is how Journal Sentinel deputy managing editor Greg Borowski describes the joint effort, pointing, for one, to its longevity. Because of the partnership, Borowski says the “quality of stories has gone up, depth of reporting has gone up, volume of what we’ve been able to do has gone up.” Peck confesses she wasn’t sure the partnership would last more than one year, was “really surprised by how well the content was received by our users,” and “gratified by how willing our staff was to embrace the concept and work with the Journal Sentinel folks.”
As for readers, they’ve been guided through the workings of the medical-industrial complex, the role of big money from Big Pharma in pushing pharmaceuticals, and the risks posed by many new drugs coming on the market. “The big message for patients and to some extent doctors is they may not know all the details of the safety and effectiveness of new drugs,” Fauber says. For the stories done last year, they found 14,000 deaths reported to the FDA’s adverse events reporting system after the products got on the market. Most recently, their work focused on the FDA’s use of less stringent measures of effectiveness—so-called “surrogate measures” –to fast-track approval of some drugs. For example, if a drug shrinks a tumor as evidenced by an X-ray or a lab test, it’s often approved even if there’s no proof patients will live longer or have a better quality of life. Fauber summed it up this way in December:
Journal Sentinel/MedPage investigations have found the FDA’s reliance on surrogate measures has led to a steady stream of costly drugs of dubious value over the past decade—not just in cancer, but for conditions such as diabetes, low testosterone and obesity.
On sticking, more recently, with this common thread of the FDA’s use of “surrogate measures,” the Journal Sentinel’s Borowski says “the more you do, the more their message gets into the conscience of readers and eventually to policy makers who can make a difference.” Some stories over the years have help spark Senate investigations. Both outlets say their joint work enjoys healthy readership (without giving specifics). Says Journal Sentinel deputy manging editor Borowski, “There’s also impact beyond how many people read the stories. How could you measure how many people had a better conversation with their doctors about a drug? There’s no way to tell.”
The idea you’d have an open pipeline between two news organizations sharing judgments and reporters and working in two different media cultures was a “radical proposal” in 2009, Peck says. But this is the news biz, and competitive juices still run deep. When I asked Fauber what was next on the list for this partnership, he hesitated to tell me too much. “I live in constant fear that someone will get to these stories before we do,” he said, adding that the team would continue looking for “potential harm and where regulators have not been as demanding as they should be.” Given the reality of weaker FDA regulation, there can’t be enough probing eyes on these industries. The enduring Journal Sentinel/MedPage Today partnership shows what can be done and the value of continued focus.Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.