Numerous Doctors Lined-Up to Sing Praises of Crestor for CBS News Report

There is an insightful article published in the July/August 2005 edition of the Columbia Journalism Review (CJR), Bitter Pill: How the press helps push prescription drugs, sometimes with deadly consequences, by Trudy Lieberman, a contributing editor to CJR.

In relevant part, this 2005 CJR article by Ms. Lieberman reveals the lengths to which a drug company might go to promote their prescription medicines.  In one part of the article, Ms. Lieberman discloses that AstraZeneca’s promotional efforts for Crestor (rosuvastatin) — a cholesterol-lowering agent and member of the statin class of drugs — had included an apparent attempt to influence an investigative report being prepared by CBS News correspondent Sharyl Attkisson.

The AstraZeneca conduct which is covered in this 2005 CJR article occurred when CBS News and Ms. Attkisson were preparing a story in the latter part of 2004 about Crestor.  At that time, as some may recall, there were allegations by the consumer advocacy group Public Citizen and an FDA researcher named David Graham, and various others, about whether Crestor was an unsafe drug in comparison to other cholesterol medications in the statin-drug class — namely Lipitor (atorvastatin), Zocor (simvastatin), Mevacor (lovastatin), Lescol and Lescol XL (fluvastatin), and Pravachol (pravastatin).

Some more background may be needed to put this conduct by AstraZeneca in context.  During his November 2004 congressional testimony, the FDA’s David Graham had identified Crestor as one of the five prescription drugs whose safety profile should be "looked at quite seriously." On another front, Public Citizen, the advocacy group, had petitioned the FDA to remove Crestor from the U.S. market on the grounds that Crestor had a unacceptable rate of causing rhabdomyolysis (severe muscle breakdown / toxicity) and kidney failure in some patients. Needless to say, AstraZeneca, the maker of Crestor, probably felt under some pressure given these developments.  Perhaps to fight back, AstraZeneca launched a public relations campaign which included full-page ads in major newspapers, boasting that "the FDA has confidence in the safety and efficacy of Crestor".  This aspect of the PR campaign backfired, however, as the FDA soon thereafter publicly chastised AstraZeneca for making such a claim — for the simple reason that AstraZeneca’s claim about FDA confidence in Crestor was false from the agency’s perspective.

We pick up, here, with the relevant part of Ms. Lieberman’s article, Bitter Pill:

CBS’s Attkisson thought Crestor’s troubles added up to a good story. While AstraZeneca was weighing her request for an on-camera interview, Attkisson began to receive unsolicited offers for interviews from doctors with financial ties to AstraZeneca. In one e-mail, a doctor from Rush University Medical Center in Chicago told Attkisson he had conducted numerous studies on Crestor and urged her to take him up on his offer "to ensure ALL the information about this important class of medication gets out to the public, and not just a selective interpretation of data." A second doctor, a nephrologist from the Cleveland Clinic Foundation, wrote to Attkisson that the accusations made by Public Citizen about Crestor’s safety were false, saying it was "imperative" that her story "be both factual and accurate." AstraZeneca sent Attkisson examples of other press stories quoting doctors making positive statements about Crestor. Attkisson told the company she didn’t need help finding independent experts. At that point, she says, AstraZeneca got pushy. "We got lobbied so hard on this story by doctors, two outside p.r. firms, AstraZeneca, and one crisis-management firm," she says. "They worked me and pushed me and contacted the executive producer and the president of the news division. But my bosses were generally supportive." Her Crestor story, when it finally aired in mid-December 2004, featured an AstraZeneca vice president but none of the doctors who had e-mailed Attkisson.

To date, the FDA has not seen it necessary to remove Crestor from the U.S. market.  In March 2005, the FDA did ask AstraZeneca to place stronger warning language on the package insert label for Crestor to inform doctors and patients that the use of Crestor may increase the risk of developing rhabdomyolysis.

(Posted by: Tom Lamb)