(Steven Brill is a Reuters columnist but his opinions are his
By Steven Brill
Feb 26 Let's begin this column with a quiz, one
designed to test your story-generating talents. If the answer
comes to you within 10 seconds, you, too, could be an editor or
TV news producer. If you are an editor or producer and don't see
it instantly, you need better radar.
First, read the opening two sentences from a story that
appeared in the Financial Times a few weeks ago:
"Europe's most senior justice official is adamant she will
fight US attempts to water down a proposed EU data protection
and privacy law that would force global technology companies to
obey European standards across the world. Viviane Reding, EU
commissioner for justice, said that the EU was determined to
respond decisively to any attempts by US lobbyists - many
working for large tech groups such as Google and Facebook - to
curb the EU data protection law."
What's the story that screams out to be written or televised
based on these two sentences? Hint: It's all about how
Washington has been brought to its knees by special interests.
The answer: Let's compare lobbying practices and regulations
in the United States to those in other venues, including the
European Union and its constituent countries. This story - with
its reference to the EU commissioner vowing to fight "attempts
by U.S. lobbyists," which are the words that rang the idea bell
in my head - presents the perfect backdrop for reporting I've
wanted to see for years comparing how lobbying is done, if at
all, in other developed democracies to the way lobbyists and big
money have come to dominate the agenda in Washington.
The rest of the Financial Times story explains that American
lobbyists for tech companies seem to have persuaded the U.S.
government to push back against the EU's plans to promulgate
privacy protections for consumers that would impair the ability
of companies such as Facebook and Google to collect data from
users in ways that will continue to boost their advertising
revenue. In other words, the companies' lobbyists in Washington
have recruited our government to become their lobbyists at the
One implication of that is that Google and Facebook,
juggernauts though they are, can't deploy their own lobbyists in
Belgium the way they can in Washington. Is that true? What are
the regulations or traditions that limit the effectiveness of
lobbyists in venues like the EU?
Following the battles over other big issues that cross
national borders could add texture to the story. How, for
example, have Goldman Sachs or JP Morgan Chase tried to
influence banking regulations around the world, including the
crucial Basel rules on capital and liquidity?
These questions could lead to a tour of various world
capitals describing how the influence industry works, or doesn't
work, in each place. Are the results always better? I bet not
everywhere. True, America's open system of influence peddling -
in which lobbyists have to register and report their fees - is
the embodiment of Michael Kinsley's famous observation that the
real scandal in Washington "isn't what's illegal but what's
legal." Yet a balanced approach to this story might find not
only examples of governments with a far cleaner process more
grounded in the public interest, but also places where simple
under-the-table bribes make Washington's K Street culture look
Following a wonder drug's bottom line:
This story in Saturday's New York Times about the Food and
Drug Administration approving a promising new breast cancer drug
suggests a reporting project that could produce a dramatic tale
of scientific discovery along with an important look at the
economics of the pharmaceutical industry. It could also open a
window on the health and public policy issues associated with
how we regulate drugs and drug prices and how we allocate
healthcare resources in the United States.
According to the New York Times:
"The drug, which will be called Kadcyla but was known as
T-DM1 during its development, extended the median survival of
women with advanced breast cancer by nearly half a year in a
"Genentech, which developed the drug, said it would cost
about $9,800 a month, or $94,000 for a typical course of
treatment. That is about twice the price of Herceptin itself,
which is also made by Genentech, but it is similar to the price
of some other new cancer drugs."
Many tough questions flow from just those two paragraphs.
This seems to mean that patients will get to live "nearly half a
year" extra if they or their insurance company (or Medicare if
the patient is 65 or older) pays $47,000 - the difference
between the cost of the new drug and the one a breast cancer
victim would otherwise take.
Most state laws require insurance companies to pay for any
approved cancer drug at whatever the drug company sets as its
average sales price, plus a 6 percent profit for the hospital or
doctor that dispenses it. Federal law requires Medicare to do
the same. So how much will the potential widespread adoption of
this treatment add to the national medical bill?
Of course, the benefits are clear: an extended life and,
apparently, more mild side effects than the alternative
treatments. But a reporter unafraid to step onto this minefield
would also ask experts to talk about whether anyone should be
making the kind of cost-benefit analysis that would consider
whether that money could be spent more effectively on other
healthcare needs. But even before getting to those delicate
issues about the value of life, there's the question of how the
drug company arrived at that $94,000 treatment price? Why does
it have to be that much?
Which leads to the question of how much the approval of the
new drug at $94,000 per treatment in the U.S. will add to the
profits of Roche, the $45 billion global drug company that
distributes it - and if that's a fair result compared to the
pricing regulations in effect in other countries that would
limit those profits.
The New York Times story reports that Genentech, the
California-based biotechnology pioneer that is now a subsidiary
of Roche, "developed the drug." However, according to the Times,
"The linker and toxin used in Kadcyla were developed by
ImmunoGen, based in Waltham, Mass., which will receive royalties
on sales of the drug. This is the first approved product for
ImmunoGen, which has been working on antibody-drug conjugates
for three decades."
That makes me want to know more not just about ImmunoGen but
also about the scientists there who actually invented the
treatment. Was the same person or team really working away at
this for "three decades"? Let's meet them and describe their
struggle to create this treatment.
Then let's go back to the money story. Did the ability of
Genentech and Roche to manufacture, market and distribute the
drug around the world make it irresistible for ImmunoGen to sell
off the rights to its invention in return for royalties? How
much might the royalties turn out to be? Is this an
Instagram-like payday for the folks in that Waltham lab?
And what did ImmunoGen and Genetech have to invest in
research and development before they hit paydirt? What were the
costs and processes involved in gaining FDA approval?
In short, I'd really love to see a narrative - with all the
people, as well as all the numbers - telling us the story of the
new wonder drug and how it brings to life all the issues
involved in modern healthcare.
( Steven Brill, the author of Class Warfare: Inside the Fight
To Fix America's Schools, has written for magazines including
New York, The New Yorker, Time, Harpers, and The New York Times
Magazine. He founded and ran Court TV, The American Lawyer
Magazine, ten regional legal newspapers, and Brill's Content
Magazine. He also teaches journalism at Yale, where he founded
the Yale Journalism Initiative. His latest published work is
"Bitter Pill," a special report in the March 4 issue of TIME on
medical bills. )