Complete Health Reporting: Always Ask About Costs
Health writer and editor Andy McPhee asked me recently to give a guest lecture during his class at Drexel University.
He knew I write reviews for HealthNewsReview.org and suggested I explain the 10 criteria we use to rate health stories. They are essential ingredients for any writer trying to cover a new treatment or trend in health and medicine. I often wish that some of my early health stories had been reviewed so that I might have seen some of the holes in my coverage. In that spirit, I decided to write a series of posts offering tips based on the 10 criteria. The first is below, and the rest will follow in the coming weeks.
Never write a story about a health-related treatment without talking about costs.
Health writers should stitch "What does it cost?" onto their pillows so they can see it every morning when they wake up. This is the single biggest pitfall for most of the stories we review. A story can cover every other aspect of a new treatment, drug or device perfectly but still forget to include any information about costs. As HealthNewsReview.org publisher Gary Schwitzer has noted, 70% of the stories reviewed have received unsatisfactory grades for leaving out cost information.
What should you be asking? Here are some key questions:
1. What are the immediate costs to patients and insurers, including Medicare? A connected question is whether insurance companies and Medicare even cover the intervention.
2. What are the associated costs? For example, if you are writing about a new type of device for the heart, you should discuss the cost of the surgery to implant it and the follow-up care.
3. How long is the course of treatment? If you are going to talk about costs in terms of a cost per pill or cost per day, you need to explain what a typical course of treatment involves. For example, you might say, "the pills only cost $1 a day," but if patients have to take them for the rest of their lives, the cumulative costs add up.
Matthew Perrone at the Associated Press provided a particularly good example of how to write about costs with a story he did in November 2011 on a new type of screening for melanoma. He discussed costs from three different angles: the cost to the physician, the patient and the insurers.
Doctors will pay a one-time fee of $7,500 to lease and receive training on the device. Patients will pay $150 out of pocket for a MelaFind scan, which analysts say may limit use to more affluent patients who are willing to pay extra for the latest medical care. Mela Sciences does not plan to ask insurers to cover the device until several years from now, after it is more widely used.
Even in a business story, beyond reporting the net worth of the company and the projected market potential for a new drug or device, there is room to explore the potential cost to the consumer and to insurers. This, too, helps the target audience – people interested in the stock market and the economy – understand the possible impact of the drug or device.
It may be difficult to estimate costs of an experimental approach that is very early in its development. But you can always cite the costs of existing alternatives. If it's not too early to talk about how well something might work, then it's not too early to start discussing what it may cost.
One of the first places I go when I want to know just the basic cost of a drug is Drugstore.com, which, unlike other pharmacy sites, gives cost information for both prescription-only and over-the-counter drugs.
Photo credit: Images Money via Flickr