Wednesday, November 14, 2007

Cultivating Astroturf

We have previously posted about "astroturf movements," defined as artificial grass-roots movements bankrolled by corporations, and their applications in health care. It seems to be the season to cultivate astroturf (it is the US football season).

The Wall Street Journal reported how Amgen "is pouring millions of dollars into a lobbying campaign to get Congress to change a Medicare rule that dealt a big blow to the company's lucrative anemia drugs." Part of this effort appeared to be an astroturf campaign,

Since the summer, the company has run an Internet-centered campaign, Protect Cancer Patients, that tries to capture the feel of a grass-roots effort by encouraging cancer patients, survivors and family members to send in their stories and to upload video and audio testimonials. The Web site also encourages individuals to phone members of Congress.

"We were very interested in making sure that the Medicare beneficiaries had a vehicle to make their voices heard," says Josh Ofman, Amgen's vice president of global reimbursement and payment policy. The company says it has already generated hundreds of emails and phone calls to lawmakers.

But on Friday Amgen said it had suspended the site as part of a re-evaluation of its online campaign. The company said the decision was unrelated to a report in the Cancer Letter, an influential newsletter, suggesting that testimonials on the site advocating off-label uses of the drug could violate Food and Drug Administration marketing rules. [NB - the web-site now appears to be down. But a cached version is still found here.]

And Johnson & Johnson is up to something similar,

Last week, Johnson & Johnson launched a similar effort for its anemia-fighting drug, Procrit [epoetin alpha], with a Web site,, that allows individuals to send emails to the Center for Medicare and Medicaid Services and contact their representatives in Washington. The site doesn't include patient testimonials.

The Wall Street Journal report did not call these astroturf campaigns, but used the euphemism, "indirect grass-roots campaigns,"

Indirect grass-roots campaigns have become a popular tactic among lobbyists because they focus the issue away from a powerful entity and toward ordinary people who would ostensibly suffer if the government fails to respond. In this case, the front group is especially sympathetic.

Astroturf by any other name is still artificial.

Meanwhile, as reported by Ed Silverman on PharmaLot, there is opposition to Consumer Union's (CUs) hilarious counter-advertisement on restless legs syndrome (RLS). A video of the counter-advertisement appears here.

The Executive Director of the Restless Legs Syndrome Foundation, Georgianna Bell, wrote a letter to CU harshly critical of its counter-advertisement. She did not point out in the letter that her organization receives major funding from the manufacturers of drugs for RLS (see previous post here). GlaxoSmithKline (GSK) contributed over $250,000 a year over the most recent two years covered by the Foundation's annual reports (2006 and 2005). GSK, of course, makes Requip [ropinirole]. Boehringer Ingelheim Pharmaceuticals Inc, the manufacturer of Mirapex [pramipexole] approved in 2006 by the US Food and Drug Administration to treat RLS, gave over $150,000 in the most recent year.

Once again, you can't tell the players in health care without a scorecard. I see nothing wrong with commercial health care firms expressing their point of view. But astroturf campaigns are fundamentally deceptive. If biotechnology, pharmaceutical, device and other health care companies do not want to be regarded as "shifty," they ought to cease such stealth marketing and stealth health lobbying, and stop cultivating astroturf in particular.

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