David Warsh: The exciting lives of former newspapermen

— Photo by Knowtex

SOMERVILLE, Mass.

After the Internet laid waste to old monopolies on printing presses and broadcast towers, new opportunities arose for inhabitants of newsrooms. That much I knew from personal experience. With it in mind, I have been reading Spooked: The Trump Dossier, Black Cube, and the Rise of Private Spies (Harper, 2021), by Barry Meier, a former reporter for The New York Times and The Wall Street Journal. Meier also wrote Pain Killer: A “Wonder” Drug’s Story of Addiction and Death (Rodale, 2003), the first book to dig in to the story of the Sackler family, before Empire of Pain: The Secret History of the Sackler Dynasty (Doubleday, 2021), by New Yorker writer Patrick Radden Keefe, eclipsed it earlier this year.  In other words, Meier knows his way around. So does Lincoln Millstein, proprietor of The Quietside Journal, a hyperlocal Web site covering three small towns on the southwest side of Mt. Desert Island, in Downeast Maine.

Meier’s book is essentially a story about Glenn Simpson, a colorful star investigative reporter for the WSJ who quit in 2009 to establish Fusion GPS, a private investigative firm for hire.  It was Fusion GPS that, while working first for Republican candidates in early 2016, then for Hillary Clinton’s presidential campaign, hired former MI6 agent Christopher Steele to investigate Donald Trump’s activities in Russia.

Meier, a careful reporter and vivid writer, doesn’t think much of Simpson, still less of Steele, but I found the book frustrating: there were too many stories about bad behavior in the far-flung private intelligence industry, too loosely stitched together, to make possible a satisfying conclusion about the circumstances in which the Steele dossier surfaced, other than information, proven or not, once assembled and packaged, wants to be free. William Cohan’s NYT review of Spooked was helpful: “[W]e are left, in the end, with a gun that doesn’t really go off.”

Meier did include in his book (and repeat in a NYT op-ed) a telling vignette about  Fusion GPS co-founder Peter Fritsch, another former WSJ staffer who in his 15-year career at the paper had served as bureau chief in several cities around the world. At one point, Fritsch phones WSJ reporter John Carreyrou, ostensibly seeking guidance on the reputation of a whistleblower at a medical firm – without revealing that Fusion GPS had begun working for Elizabeth Holmes, of whose blood-testing start-up, Theranos, Carreyrou had begun an investigation.

Fritsch’s further efforts to undermine Carreyrou’s investigation failed. Simpson and Fritch tell their story of the Steele dossier in Crime in Progress (2019, Random House.) I’d like to someday read more personal accounts of their experiences in the private spy trade, I thought, as I put Spooked and Crime in Progress back on the shelf  Given the authors’ new occupations, it doesn’t seem likely those accounts will be written.

By then, Meier’s story had got me thinking about Carreyrou himself. His brilliant reporting for the WSJ, and his 2018 best-seller, Bad Blood: Secrets and Lies in a Silicon Valley Startup (Knopf, 2018, led to Elizabeth Holmes’s trial on criminal charges that began last month in San Jose. Thanks to Twitter, I found, within an hour of its appearance, this interview with Carreyrou, now covering the trial online as an independent journalist.

My head spun at the thought of the leg-push and tradecraft required to practice journalism at these high altitudes. The changes wrought by the advent of the Web and social media have fundamentally expanded the business beyond the days when newspapers and broadcast news were the primary producers of news. In 1972, when I went to work for the WSJ, for example, the entire paper ordinarily contained only four bylines a day.

So I turned with some relief to The Quietside Journal, the Web site where retired Hearst executive Lincoln Millstein covers events in three small towns on Mt. Desert Island, Maine, for some 17,000 weekly readers. In an illuminating story about his enterprise, Millstein told Rick Edmonds, of the Poynter Institute, that he works six days a week, again employing pretty much the same skills he acquired when he covered Middletown, Conn., for The Hartford Courant forty years ago. (Millstein put the Economic Principals column in business in 1984, not long after he arrived as deputy business editor at The Boston Globe).

My case is different. Like many newspaper journalists in the 1980s,  I worked four or five days a week at my day job and spent vacations and weekends writing books. I quit the day job in 2002, but kept the column and finished the book. (It was published in 2006 as Knowledge and the Wealth of Nations: A Story of Economic Discovery).  
Economic Principals subscribers have kept the office open ever since; I gradually found another book to write; and so it has worked out pretty well. The ratio of time spent is reversed: four days a week for the book, two days for the column, producing, as best I can judge, something worth reading on Sunday morning. Eight paragraphs, sometimes more, occasionally fewer: It’s a living, an opportunity to keep after the story, still, as we used to say, the sport of kings.

David Warsh, a veteran columnist and an economic historian, is proprietor of Somerville-based economicprincipals.com, where this essay first ran.

The Opioid Billionaire Sacklers at Tufts

At the Tufts University School of Medicine, in Boston. Tufts’s main campus is in Medford.

From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com

A disturbing story in the corrupting money chase in higher education has taken place at the Tufts University School of Medicine. There, the school acted from time to time in effect as a shill for Purdue Pharma. That’s the maker of opioid painkillers whose irresponsible (and worse) marketing of opioids at the relentless orders of the outstandingly greedy and status-obsessed Sackler family, which controls the company, has killed many thousands of patients. In what now seems incredible, people connected with Purdue had asserted for several years that their hugely lucrative drug OxyContin wasn’t addictive. All opioids are addictive.

STAT, the health-care news service, reported:

“A STAT review of court documents, two decades of academic papers, tax forms, and funding disclosures suggests that the family and company money that went to Tufts helped to advance their interests, generating goodwill for members of the family who were praised for their philanthropy and amplifying arguments about opioids that dovetailed with their business aims.’’

At one time, a Purdue executive, Dr. David Haddox, was a professor at the school, where he lectured on pain management.

A Massachusetts state lawsuit against Purdue said that the company’s and the Sacklers’ funding enabled it “to control research on the treatment of pain coming out of a prominent and respected institution of learning.’’

To read the STAT article, please hit this link.

Victoria Knight: The more opioid marketing, the more overdose deaths

Oxycodone, sold under brand name OxyContin among others, is an opioid medication used for treatment of moderate to severe pain. OxyContin was heavily marketed by the Sackler family’s Purdue Pharma, in the process leading to many overdose deaths.

By VICTORIA KNIGHT

For Kaiser Health News

Researchers sketched a vivid line on Jan. 18 linking the dollars spent by drugmakers to woo doctors around the country to a vast opioid epidemic that has led to tens of thousands of deaths.

The study, published in JAMA Network Open, looked at county-specific federal data and found that the more opioid-related marketing dollars were spent in a county, the higher the rates of doctors who prescribed those drugs and, ultimately, the more overdose deaths occurred in that county.

For each three additional payments made to physicians per 100,000 people in a county, opioid overdose deaths were up 18 percent, according to the study. The researchers said their findings suggest that “amid a national opioid overdose crisis, reexamining the influence of the pharmaceutical industry may be warranted.”

And the researchers noted that marketing could be subtle or low-key. The most common type: meals provided to doctors.

Dr. Scott Hadland, the study’s lead author and an addiction specialist at Boston Medical Center’s Grayken Center for Addiction, has conducted previous studies connecting opioid marketing and opioid prescribing habits.

“To our knowledge, this is the first study to link opioid marketing to a potential increase in prescription opioid overdose deaths, and how this looks different across counties and areas of the country,” said Hadland, who is also a pediatrician.

Nearly 48,000 people died of opioid overdoses in 2017, about 68 percent of the total overdose deaths, according to the Centers for Disease Control and Prevention. Since 2000, the rate of fatal overdoses involving opioids has increased 200 percent. The study notes that opioid prescribing has declined since 2010, but it is still three times higher than in 1999.

The researchers linked three data sets: the Centers for Medicare & Medicaid Services Open Payments database that shows drugmakers’ payments to doctors; a database from the CDC that shows opioid prescribing rates; and another CDC set that provides mortality numbers from opioid overdoses.

They found that drugmakers spent nearly $40 million from Aug. 1, 2013, until the end of 2015 on marketing to 67,500 doctors across the country.

Opioid marketing to doctors can take various forms, although the study found that the widespread practice of providing meals for physicians might have the greatest influence. According to Hadland, prior research shows that meals make up nine of the 10 opioid-related marketing payments to doctors in the study.

“When you have one extra meal here or there, it doesn’t seem like a lot,” he said. “But when you apply this to all the doctors in this country, that could add up to more people being prescribed opioids, and ultimately more people dying.”

Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management, said these meals may happen at conferences or industry-sponsored symposiums.

“There are also doctors who take money to do little small-dinner talks, which are in theory, supposed to educate colleagues about medications over dinner,” said Kolodny, who was not involved in the study. “In reality this means doctors are getting paid to show up at a fancy dinner with their wives or husbands, and it’s a way to incentivize prescribing.”

And those meals may add up.

“Counties where doctors receive more low-value payments is where you see the greatest increases in overdose rates,” said Magdalena Cerdá, a study co-author and director of the Center for Opioid Epidemiology and Policy at the New York University School of Medicine. The amount of the payments “doesn’t seem to matter so much,” she said, “but rather the opioid manufacturer’s frequent interactions with physicians.”

Dr. , who is the co-director of the Johns Hopkins Center for Drug Safety and Effectiveness and was not affiliated with the study, said that the findings about the influence of meals aligns with social science research.

“Studies have found that it may not be the value of the promotional expenditures that matters, but rather that they took place at all,” he said. “Another way to put it, is giving someone a pen and pad of paper may be as effective as paying for dinner at a steakhouse.”

The study says lawmakers should consider limits on drugmakers’ marketing “as part of a robust, evidence-based response to the opioid overdose epidemic.” But they also point out that efforts to put a high-dollar cap on marketing might not be effective since meals are relatively cheap.

In 2018, the New Jersey attorney general implemented a rule limiting contracts and payments between physicians and pharmaceutical companies to $10,000 per year.

The California Senate also passed similar legislation in 2017, but the bill was eventually stripped of the health care language.

The extent to which opioid marketing by pharmaceutical companies fueled the national opioid epidemic is at the center of more than 1,500 civil lawsuitsaround the country. The cases have mostly been brought by local and state governments. U.S. District Judge Dan Polster, who is overseeing hundreds of the cases, has scheduled the first trials for March.

In 2018, Kaiser Health News published a cache of Purdue Pharma’s marketing documents that displayed how the company marketed OxyContin to doctors beginning in 1995. Purdue Pharma announced it would stop marketing OxyContin last February.

Priscilla VanderVeer, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, or PhRMA, said that doctors treating patients with opioids need education about benefits and risks. She added that it is “critically important that health care providers have the appropriate training to offer safer and more effective pain management.”

Cerdá said it is also important to consider that the study is not saying doctors change their prescribing practices intentionally.

“Our results suggest that this finding is subtle, and might not be recognizable to doctors that they’re actually changing their behavior,” said Cerdá. “It could be more of a subconscious thing after increased exposure to opioid marketing.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Victoria Knight: vknight@kff.org, @victoriaregisk