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TYNDALL HEADLINE: HIGHLIGHTS FROM MAY 21, 2007
A $3bn-a-year pill sold by the pharmaceutical company GlaxoSmithKline may have killed tens of thousands of patients since it was approved eight years ago. The pill, brand name Avandia, lowers a diabetic's levels of blood sugar. Unfortunately, if research by Dr Steven Nissen at the Cleveland Clinic is correct, it also helps cause fatal heart attacks. All three networks led with the prospect of such a calamitous death toll, making it the Story of the Day. For its part Glaxo "strongly disagrees" with Nissen's conclusions and will continue to sell the medicine.
TYNDALL PICKS FOR MAY 21, 2007: CLICK ON GRID ELEMENTS TO SEARCH FOR MATCHING ITEMS
KILLER PILL A $3bn-a-year pill sold by the pharmaceutical company GlaxoSmithKline may have killed tens of thousands of patients since it was approved eight years ago. The pill, brand name Avandia, lowers a diabetic's levels of blood sugar. Unfortunately, if research by Dr Steven Nissen at the Cleveland Clinic is correct, it also helps cause fatal heart attacks. All three networks led with the prospect of such a calamitous death toll, making it the Story of the Day. For its part Glaxo "strongly disagrees" with Nissen's conclusions and will continue to sell the medicine.
Being the venue for such heavy advertising by Big Pharma, the networks' nightly newscasts are under an obligation to make a special effort when such news breaks. Not only is their audience older than the population at large, and therefore more likely to use prescription drugs; also, their journalism is so surrounded by marketing messages reassuring the audience that medicine will make them better that any plausible contrary message--that it might kill them--needs to be transmitted not only loud and clear, but louder and clearer than a normal news development.
So each newscast acquitted itself ethically by leading with Avandia and following up with an expert interview. ABC and CBS chose their in-house physicians; NBC talked to a professor of medicine at Harvard.
The ethics may have been fine. The statistics were less impressive. ABC's John McKenzie quoted Nissen as having calculated a 64% "increased risk of dying from heart disease compared to patients on other treatments or getting no treatments at all." His anchor Charles Gibson told us that a total of six million diabetes patients have taken Avandia since it was approved and CBS anchor Katie Couric estimated that "about a million" take it now.
So far so good. But that 64% statistic does not mean much without knowing what the heart risk is for diabetics who are not taking Avandia. If it happens to be 1%, then taking the medication merely increases the chance of death to 1.64%, no big deal. Conversely if the non-Avandia risk were to be 60%, then the hike from the medication would be to 98%, a very big deal indeed. NBC's Robert Bazell, to his credit, tried to get an answer from Nissen himself. "How many extra deaths a year could it be causing?" "It certainly would be tens of thousands. The exact magnitude of it remains to be calculated."
Second, even if Avandia does make death from a heart attack more likely, does it make death from diabetes less likely? Both ABC's McKenzie and CBS' Wyatt Andrews quoted Glaxo's assertion that the benefits of taking the drug "continue to outweigh any treatment risks." But here again, none of the reports attached any numbers to those claims.
Over to the physicians for their expert analyses. CBS' Jon LaPook described the Cleveland Clinic's method: "They rolled up a bunch of smaller studies, 42 of them." He insisted: "There are problems with doing that." ABC's Timothy Johnson (at the tail of the McKenzie videostream) questioned the FDA's initial approval of Avandia. It found a benefit solely because laboratory tests proved that it improved blood sugar levels. The FDA ordered no "long-term studies that showed it actually prevented the dreaded complications of diabetes," namely diseases of the heart, the eye and the kidney.
On NBC, Harvard's Jerry Avorn (at the tail of the Bazell videostream), author of Powerful Medicines pointed the finger at the Food & Drug Administration for its failure to monitor the safety of prescription drugs, post-approval. His advice for diabetic users of Avandia was that they should first "call their doctor" and "the second call patients should make is probably to their congressman" to call for a better FDA safety system.
REFINING PROFITS Another week, another nationwide survey of gasoline prices. "The price rise at the pump has been relentless," announced CBS' Anthony Mason as the average for a gallon closed in on $3.25. Mason gave us some trend numbers: nationwide consumption is 16% greater than ten years ago; the cost of a gallon is 30c higher than just a year ago. "The recent pain at the pump is not due to high crude oil prices," ABC's Lisa Stark (subscription required) stated. The refinery business is the problem, with outages at 30 of the nation's 149 refineries cutting daily gasoline production by 400K barrels. The upshot is "a perfect situation for profits" with earnings of $40 on each refined barrel. Exxon's profits from refinery operations are 50% higher this year than last.
BANK ROBBERY ESCALATES There was only one international story to warrant coverage by a correspondent. All three networks reported on the fighting at a Palestinian refugee camp in Lebanon--although none had a reporter on the scene. From London, CBS' Mark Phillips recounted that the conflict "began as a police operation following a bank robbery." The thieves were suspected of being members of the militant Fatah al-Islam organization. Many were "fresh from fighting with the insurgents in Iraq," noted ABC's Wilf Dinnick (subscription required) from Jerusalem.
They took refuge in the Nahr al-Bared camp in Tripoli. Dinnick noted that "the Lebanese government is forbidden by law" from entering the Palestinian camps so the army laid siege, shelling it from a distance. Concluded NBC's Richard Engel from London: "Now there is no electricity in the camp of 40,000. Bread, medicine and water are running out." Engel added that when NBC visited the camp two weeks ago, Shakir al-Absi, the leader of Fatah al-Islam, "openly bragged" about training his fighters to go on the attack "around the world." His goal is "to topple Prime Minister Fouad Siniora's fragile government" in Beirut.
BLOODY BUSINESS Debate over immigration legislation began in the Senate and CBS' Jim Axelrod noticed that its was already beginning "to be picked apart" as many Republicans denounced its amnesty provisions while Democrats worried about the creation of a permanent underclass from the guestworkers it would legalize. As frictions mounted, Axelrod reported that Sen John McCain, a supporter and Annapolis graduate, was "apparently cursing like a sailor" at his Texan colleague John Cornyn. "The White House wants a big victory" for President George Bush's legacy. "This is going to be a delicate coalition to keep together."
The dark side of immigration was the topic of the first part of Pierre Thomas' series Slavery in America on ABC. There may be 15,000 foreigners smuggled into this country and held in indentured servitude working in fields, homes, sweatshops and brothels. Thomas dramatized their plight by telling the story of Evelyn Chumbow, who was shipped to Silver Spring in the Maryland suburbs of Washington from Cameroon at the age of eleven in 1996 and held captive for two years as a domestic slave before she escaped. Once her mistress, Theresa Mubang, beat her with a metal broom: "She has a white carpet," so her orders after the beating were: "Go! Clean your stinking blood up." Mubang is now serving 17 years in a federal prison. Chumbow was granted an immigration visa in exchange for her testimony against Mubang and hopes to work in the Peace Corps.
MADE TO BE BROKEN The comeback from Hurricane Katrina led NBC's newscast with Martin Savidge's progress report last Friday. Now it is the topic of CBS' feature series The American Spirit. Kelly Cobiella profiled Doris Voitier, the superintendent of schools for Louisiana's St Bernard Paris. When all of her 15 schools were flooded out she succeeded by "ignoring the bureaucracy of FEMA" and going into debt to refurbish her schools. Before the hurricane, "would you have considered yourself a rebel?" "Not really," Voitier replied, "I was basically--as most teachers are and most educators--a rule follower but I quickly saw that in a crisis situation you had to throw all that out because nothing would get done." And sitting on FEMA's desk to this day is a bill for $15m to repay St Bernard's debts.
VIRTUAL VICE & VIRTUE A pair of odd online stories appeared on NBC and ABC. ABC's Dan Harris (no link) told us about the specially designed software used by myspace.com to search its user profiles for names that match those of registered former inmates who were convicted of sexual offenses. So far it has found 7,000 matched names out of its 180m user profiles: "With 300,000 people joining their site every day this is a massive undertaking"--and probably not a very productive one since "savvy predators" are unlikely to use their real names.
NBC's Don Teague visited the virtual world of Second Life where he found "a new religious frontier." Its virtual cities include churches, synagogues and mosques that are actually real. An evangelical Christian megachurch in Oklahoma City is a case in point: Life Church pays to have its Sunday sermons literally simulcast in Second Life where avatars virtually attend to listen. Teague introduced us to one worshipper who "came to church as a cheetah wearing shorts."
SPECTATOR SPORT NBC's closer was the animal tale of the pair of humpback whales whose migration was interrupted when they took a wrong turn at the Golden Gate Bridge. They swam into San Francisco Bay and up freshwater rivers 90 miles inland to Sacramento. At the state capital over the weekend, Jennifer London estimated a crowd of "nearing 15,000 squeezed in along the shoreline" to go whalewatching. The marine mammals have now started to head back to the ocean although they "appeared reluctant" to swim underneath a bridge at Rio Vista. CBS' Sandra Hughes wished them luck for the upcoming "hard part--mile after mile of tempting wrong turns for an already disoriented duo."
MENTIONED IN PASSING The network newscasts do not assign correspondents to all of the news of the day. If Tyndall Report readers come across videostreamed reports online of stories that were mentioned only in passing, post the link in comments for us to check out.
Today's examples: Democratic Presidential contender Bill Richardson officially announced his candidacy…Florida will hold its 2008 primary one week before Super Tuesday…the C19th sail-powered tea clipper Cutty Sark, now a London tourist attraction, was damaged by fire while in dry dock…the Supreme Court allowed parents of autistic children to sue their school boards for special education without having to hire a lawyer.
Being the venue for such heavy advertising by Big Pharma, the networks' nightly newscasts are under an obligation to make a special effort when such news breaks. Not only is their audience older than the population at large, and therefore more likely to use prescription drugs; also, their journalism is so surrounded by marketing messages reassuring the audience that medicine will make them better that any plausible contrary message--that it might kill them--needs to be transmitted not only loud and clear, but louder and clearer than a normal news development.
So each newscast acquitted itself ethically by leading with Avandia and following up with an expert interview. ABC and CBS chose their in-house physicians; NBC talked to a professor of medicine at Harvard.
The ethics may have been fine. The statistics were less impressive. ABC's John McKenzie quoted Nissen as having calculated a 64% "increased risk of dying from heart disease compared to patients on other treatments or getting no treatments at all." His anchor Charles Gibson told us that a total of six million diabetes patients have taken Avandia since it was approved and CBS anchor Katie Couric estimated that "about a million" take it now.
So far so good. But that 64% statistic does not mean much without knowing what the heart risk is for diabetics who are not taking Avandia. If it happens to be 1%, then taking the medication merely increases the chance of death to 1.64%, no big deal. Conversely if the non-Avandia risk were to be 60%, then the hike from the medication would be to 98%, a very big deal indeed. NBC's Robert Bazell, to his credit, tried to get an answer from Nissen himself. "How many extra deaths a year could it be causing?" "It certainly would be tens of thousands. The exact magnitude of it remains to be calculated."
Second, even if Avandia does make death from a heart attack more likely, does it make death from diabetes less likely? Both ABC's McKenzie and CBS' Wyatt Andrews quoted Glaxo's assertion that the benefits of taking the drug "continue to outweigh any treatment risks." But here again, none of the reports attached any numbers to those claims.
Over to the physicians for their expert analyses. CBS' Jon LaPook described the Cleveland Clinic's method: "They rolled up a bunch of smaller studies, 42 of them." He insisted: "There are problems with doing that." ABC's Timothy Johnson (at the tail of the McKenzie videostream) questioned the FDA's initial approval of Avandia. It found a benefit solely because laboratory tests proved that it improved blood sugar levels. The FDA ordered no "long-term studies that showed it actually prevented the dreaded complications of diabetes," namely diseases of the heart, the eye and the kidney.
On NBC, Harvard's Jerry Avorn (at the tail of the Bazell videostream), author of Powerful Medicines pointed the finger at the Food & Drug Administration for its failure to monitor the safety of prescription drugs, post-approval. His advice for diabetic users of Avandia was that they should first "call their doctor" and "the second call patients should make is probably to their congressman" to call for a better FDA safety system.
REFINING PROFITS Another week, another nationwide survey of gasoline prices. "The price rise at the pump has been relentless," announced CBS' Anthony Mason as the average for a gallon closed in on $3.25. Mason gave us some trend numbers: nationwide consumption is 16% greater than ten years ago; the cost of a gallon is 30c higher than just a year ago. "The recent pain at the pump is not due to high crude oil prices," ABC's Lisa Stark (subscription required) stated. The refinery business is the problem, with outages at 30 of the nation's 149 refineries cutting daily gasoline production by 400K barrels. The upshot is "a perfect situation for profits" with earnings of $40 on each refined barrel. Exxon's profits from refinery operations are 50% higher this year than last.
BANK ROBBERY ESCALATES There was only one international story to warrant coverage by a correspondent. All three networks reported on the fighting at a Palestinian refugee camp in Lebanon--although none had a reporter on the scene. From London, CBS' Mark Phillips recounted that the conflict "began as a police operation following a bank robbery." The thieves were suspected of being members of the militant Fatah al-Islam organization. Many were "fresh from fighting with the insurgents in Iraq," noted ABC's Wilf Dinnick (subscription required) from Jerusalem.
They took refuge in the Nahr al-Bared camp in Tripoli. Dinnick noted that "the Lebanese government is forbidden by law" from entering the Palestinian camps so the army laid siege, shelling it from a distance. Concluded NBC's Richard Engel from London: "Now there is no electricity in the camp of 40,000. Bread, medicine and water are running out." Engel added that when NBC visited the camp two weeks ago, Shakir al-Absi, the leader of Fatah al-Islam, "openly bragged" about training his fighters to go on the attack "around the world." His goal is "to topple Prime Minister Fouad Siniora's fragile government" in Beirut.
BLOODY BUSINESS Debate over immigration legislation began in the Senate and CBS' Jim Axelrod noticed that its was already beginning "to be picked apart" as many Republicans denounced its amnesty provisions while Democrats worried about the creation of a permanent underclass from the guestworkers it would legalize. As frictions mounted, Axelrod reported that Sen John McCain, a supporter and Annapolis graduate, was "apparently cursing like a sailor" at his Texan colleague John Cornyn. "The White House wants a big victory" for President George Bush's legacy. "This is going to be a delicate coalition to keep together."
The dark side of immigration was the topic of the first part of Pierre Thomas' series Slavery in America on ABC. There may be 15,000 foreigners smuggled into this country and held in indentured servitude working in fields, homes, sweatshops and brothels. Thomas dramatized their plight by telling the story of Evelyn Chumbow, who was shipped to Silver Spring in the Maryland suburbs of Washington from Cameroon at the age of eleven in 1996 and held captive for two years as a domestic slave before she escaped. Once her mistress, Theresa Mubang, beat her with a metal broom: "She has a white carpet," so her orders after the beating were: "Go! Clean your stinking blood up." Mubang is now serving 17 years in a federal prison. Chumbow was granted an immigration visa in exchange for her testimony against Mubang and hopes to work in the Peace Corps.
MADE TO BE BROKEN The comeback from Hurricane Katrina led NBC's newscast with Martin Savidge's progress report last Friday. Now it is the topic of CBS' feature series The American Spirit. Kelly Cobiella profiled Doris Voitier, the superintendent of schools for Louisiana's St Bernard Paris. When all of her 15 schools were flooded out she succeeded by "ignoring the bureaucracy of FEMA" and going into debt to refurbish her schools. Before the hurricane, "would you have considered yourself a rebel?" "Not really," Voitier replied, "I was basically--as most teachers are and most educators--a rule follower but I quickly saw that in a crisis situation you had to throw all that out because nothing would get done." And sitting on FEMA's desk to this day is a bill for $15m to repay St Bernard's debts.
VIRTUAL VICE & VIRTUE A pair of odd online stories appeared on NBC and ABC. ABC's Dan Harris (no link) told us about the specially designed software used by myspace.com to search its user profiles for names that match those of registered former inmates who were convicted of sexual offenses. So far it has found 7,000 matched names out of its 180m user profiles: "With 300,000 people joining their site every day this is a massive undertaking"--and probably not a very productive one since "savvy predators" are unlikely to use their real names.
NBC's Don Teague visited the virtual world of Second Life where he found "a new religious frontier." Its virtual cities include churches, synagogues and mosques that are actually real. An evangelical Christian megachurch in Oklahoma City is a case in point: Life Church pays to have its Sunday sermons literally simulcast in Second Life where avatars virtually attend to listen. Teague introduced us to one worshipper who "came to church as a cheetah wearing shorts."
SPECTATOR SPORT NBC's closer was the animal tale of the pair of humpback whales whose migration was interrupted when they took a wrong turn at the Golden Gate Bridge. They swam into San Francisco Bay and up freshwater rivers 90 miles inland to Sacramento. At the state capital over the weekend, Jennifer London estimated a crowd of "nearing 15,000 squeezed in along the shoreline" to go whalewatching. The marine mammals have now started to head back to the ocean although they "appeared reluctant" to swim underneath a bridge at Rio Vista. CBS' Sandra Hughes wished them luck for the upcoming "hard part--mile after mile of tempting wrong turns for an already disoriented duo."
MENTIONED IN PASSING The network newscasts do not assign correspondents to all of the news of the day. If Tyndall Report readers come across videostreamed reports online of stories that were mentioned only in passing, post the link in comments for us to check out.
Today's examples: Democratic Presidential contender Bill Richardson officially announced his candidacy…Florida will hold its 2008 primary one week before Super Tuesday…the C19th sail-powered tea clipper Cutty Sark, now a London tourist attraction, was damaged by fire while in dry dock…the Supreme Court allowed parents of autistic children to sue their school boards for special education without having to hire a lawyer.
