The Case Of The “Missing†Vioxx Data: NEJM, CYA and PR
On Monday, the Wall Street Journal published a front-page story containing some interesting revelations about the New England Journal of Medicine’s (NEJM) handling of a November 2000 article comparing Vioxx’s impact on stomach ulcers to naproxen. The article, written by David Armstrong, indicates that:
-NEJM may have published a December 2005 editorial “expressing concern†about the Vioxx publication to divert attention from a deposition by Executive Editor Gregory Curfman. In his deposition he admitted that the NEJM did not edit the article properly and may have helped downplay the cardiac risks associated with Vioxx.
-NEJM’s claim that the study authors deleted data from the article pertaining to Vioxx’s impact on the heart in its 2005 editorial was misleading. According to the Journal: “one of the ‘deleted items’ was a blank table that never had any data in it . . . also deleted was the number of heart attacks suffered by Vioxx users in the trial – 17.†This data was replaced with a percentage figure. .04 percent (or 17) of the 4,047 patients in the trial suffered heart attacks. Curfman later admitted that it would have been clearer to include the original figure.
-The NEJM sought counsel from a public relations consultant, Edward Caffasso, on how to manage the potential negative publicity from Curfman’s deposition. He supported the timing of the NEJM’s editorial and said it would “drive the media away from NEJM and toward the authors, Merck and plaintiff attorneys.†In addition, a list of message points provided to journal editors encouraged them to “deny that the journal’s statement was connected to the federal trial.†It is not clear who wrote the message points.
The Journal’s article does not make anyone look good. It is clear that something went wrong and that a lot of people were less than honest.
CYA At NEJM: The Buck Stops Anywhere But Here
NEJM is one of the most prestigious medical journals in the world. A vast majority of submitted articles are rejected for publication and the journal is well-respected for its editorial rigor. However, it is clear that the NEJM made some mistakes in its handling of the Vioxx article. It is also apparent that the journal is passing the buck and refusing to take responsibility for its role in the article’s publication.
Granted, the journal relies on authors to provide accurate and complete information about studies. However, given its reach and influence editors need to ensure that it asks tough questions about all studies it publishes. CYA is not an optimal strategy.
The PR Lesson: Sometimes Spin Boomerangs
The NEJM was worried that Curfman’s deposition and the timing of its editorial might make it look bad. So, it asked a public relations consultant for advice. The Journal article indicates that the consultant broke the first rule of crisis communications: tell the truth, the whole truth and nothing but the truth. It may make you look bad in the short run, but people will appreciate your candor.
The Journal article is a perfect object lesson on why telling the truth is better than spouting spin. You may get away with it initially, but things like this tend to come back to harm you when you least expect it. In 2005, Caffasso said: “The story is playing out exceptionally well.†Mr. Caffasso, that’s no longer the case.
John Mack over at the Pharma Marketing Blog and Derek Lowe at In the Pipeline have more on this story.
