Healthy Skepticism International News

February 2003

Healthy Skepticism 2003 Subscriber Survey: Report Part A

This is the first of a two part report on our January 2003 subscriber survey.

The aim of this survey was to better understand our current supporters, to help us to gain support for our new activities and to help inform our future planning.

This report covers demographics, how subscribers first heard about us, reasons for supporting Healthy Skepticism and subscription fees. Part B will cover our website, our activities and links with other organisations.

We have been going through a transition period from MaLAM to Healthy Skepticism. MaLAM’s focus on writing letters to drug companies was very cost effective in the 1980s but was less effective for the more subtle problems that increasingly came to our attention in the 1990s. Consequently we decided to explore new methods for achieving Our Aims. For more information see Changes MaLAM International News 2000;18:11/12

When we stopped the paper MaLAM letters we lost many Paid Subscribers. As of 11 February 2003 we had only 86 Paid Subscribers but this year numbers are increasing again. Almost all last years’ Paid subscribers have paid their subscription for 2003 already and we are gaining new Paid Subscribers at the rate of almost one a week.

We now have a stronger team than ever before and are currently undergoing a planning process to to improve our pursuit of our aims.

We thank all who answered our survey during January and early February 2003. Regardless of whether you answered the survey we invite you to comment on the findings and our conclusions.

We received responses from 27 of our 86 Paid Subscribers/Members = 31%.

(Members are Paid Subscribers who have also stated that they support our aims. For more information please see Your Options.)

There were responses from 58 of our 808 Free Subscribers = 7%.

The low response rates may have been due in part to the southern hemisphere summer holidays and the time commitments of our members. Because the response rates were low we can not generalise from those who did the survey to those who didn’t. However, we can use the survey to learn about some of our most committed supporters. We can also learn about Free Subscribers who support us enough to do the survey and so may be close to becoming Paid Subscribers if they were given more reason to give us more support.

We appreciate and will take account of the responses that came in after we had written up our findings.

Demographics
Paid Subscribers Free Subscribers
Country

Count
Australia 13
UK 3
USA 2
Sweden 2
Spain 1
Papua New Guinea 1
New Zealand 1
Northern Ireland 1
Italy 1
Canada 1
Belgium 1
Austria 1

Count
Australia 22
USA 7
Canada 5
Spain 5
South Africa 3
UK 3
Brazil 2
New Zealand 2
Colombia 1
Finland 1
Malaysia 1
Russia 1
Zimbabwe 1
Thailand 1
Turkey 1
Venezuela 1
No answer 1

Age
Mean 46.5
Median 46
Range 25-70
Mean 45
Median 45.5
Range 21-77
Occupation
Count
GP 9
Medical doctor not GP or Specialist 2
Medical student 0
Other 4
Pharmacist 3
Pharmacy student 0
Specialist 9

Other = Academic ethicist, Corporate Communications Manager, Industry Consultant, Lawyer
Count
GP 8
Medical doctor not GP or Specialist 3
Medical student 1
Other 17
Pharmacist 18
Pharmacy student 2
Specialist 9

Other = Ancient busybody, Chiropractor, Clinical Pharmacologist, Food Technologist, Health researcher, Patient activist, Medical researcher and librarian, Medical Scientist - Microbiology, Mother and human being, on leave from studying medicine (probably not going to return) - studying and working in qualitative research (health sociology, bioethics), Pharmaceutical Physician, Pharmacoepidemiology, pharmacologist, PhD student, Science and Technology Studies, researching Depression and Social Control, Professor of Social Medicine/Pharmacoepidemiologist, Project Manager - College of Pathologists, Registered Nurse

Conclusion:
The proportion of non-Australian subscribers has declined during the transition period.
Some of our Free Subscribers live in countries where our subscription price would seem very expensive but many don’t.
We do not know why there is a higher proportion of pharmacists amongst Free vs Paid subscribers.
Our future success depends on earning the support of younger people.

If you have any comments on the demographics of our subscribers, please make them in the box below:

1. How did you find out about Healthy Skepticism/MaLAM?

Number (%)
Paid Subscribers Free Subscribers
Other* 7 (26%) 8 (14%)
Can not remember
(indicating that involvement
began many years ago.) 7 (26%) 10 (17%)
Colleague 6 (22%) 17 (29%)**
Website 3 (11%) 17 (29%)***
Medical journal article**** 3 (11%) 3 (5%)
Media report 1 (4%) 3 (5%)

* Others for Paid Subscribers were knowing the founder 3, being the founder 1, NoFreeLunch 1, OXFAM 1, GP 1.
Others for Free Subscribers were hearing a lecture 2, E-drug 1, Adelaide Cochrane Colloquium 1, Therapeutic Assessment Group 1, “knowing it from the start” 1.

** Free Subscribers who heard about us from colleagues live in Australia 8, Canada 2, New Zealand 2, Spain 2, Finland 1, Malaysia 1, USA 1.

*** Free Subscribers who heard about us on a website live in Australia 4, USA 4, Brazil 2, Canada 2, Spain 2, Columbia 1, South Africa 1, Thailand 1.

****Journals for Paid Subscribers were Lancet 1, Med J Aust 1, Health Action International Newsletter 1.
Journals for Free Subscribers were Lancet 1, Brit Med J 1, can’t remember 1.

Conclusions:
Personal contact is our most effective path for gaining support so please invite anyone who might be interested in Healthy Skepticism to join us. If you would like to have some mini-pamphlets to give people who may be interested then please contact: .(JavaScript must be enabled to view this email address)
The website is also important but is not yet as effective at winning Paid Subscribers/Members as we would like. Publishing articles in medical journals is also useful for gaining Paid subscribers/Members.

If you have any comments on the topic of finding out about Healthy Skepticism, please make them in the box below:

2. Why do you support Healthy Skepticism?

We asked subscribers to rank the following, 1= most important 6 = least important)

Paid Subscribers Free Subscribers
Mean rank Rank of ranks Mean rank Rank of ranks
Support the aim of reducing harm from inappropriate marketing 1.7 1 2.4 1
Access to information about misleading drug promotion 2.9 2 2.5 2
Learn more about misleading drug promotion 3.4 3 2.4 1
Being in contact with like minded people 3.4 3 3.6 4
Healthy Skepticism International News editions 3.9 4 3.1 3

Paid Subscribers’ other reasons for supporting Healthy Skepticism: (NB All comments are in alphabetical order)

Acknowledgment & support of an important initiative

Opportunity to “think” and “ponder” on day to day practices, why we do things, opportunity to step back a little

Personal satisfaction from being involved in a cause related organisation

Self esteem

Trying to counteract the effects of “Big Business”

Free Subscribers’ other reasons for supporting Healthy Skepticism:

As a professional health advisor I am committed to the ‘truth’. HS helps me a lot

Curiosity following lecture

Fraternal solidarity!

Mother of Thimerosal devastated children

Part of committee developing pharmacovigilance guidelines for South Africa—which includes these issues.

Former International President [of MaLAM]

Drug company staff member: Personally involved in maintaining high promotional standards

To help me teach others

One Free Subscriber addressed the issue of being a Free rather than Paid subscriber thus:
Cheaper than subscribing

We also received additional comments from Paid Subscribers…

Getting ideas about how to work in my own setting to spread the message.

I am always amazed that Healthy Skepticism or MaLAM are not widely embraced by governments, by universities, by the Australian Consumers Association etc. I am particularly keen to pass on the principals in my medical eductor role.

I enjoy the regular reinforcement of my wary approach to drug company representatives. I get a laugh out of discovering more evidence of the mindless credulousness and materialistic aspirations of my colleagues.

I enjoyed the email discussion about the name change, and the aims and ideals. I did not contribute, but looked forward to reading other contributions. I would enjoy discussions such as this, on-line. I do not know anyone personally in Healthy Skepticism, but the intellectual stimulation about - as I said above, why and how we do things, and how we can change the way we practice day to day, is challenging, and why I have continued to belong for a long period.

Important to support action locally and internationally.

It’s difficult to rank my reasons, since they are all connected in some view, at least for me.

Morality!!!!!!!!!!

Please, don’t change yourself!

...and from Free Subscribers:

As a HAI activist and Social Medicine Professor in Brazil I have found the website to be a very important support for my activities.

Before the start of the on-line version, we found some interesting information in your newsletter which we were able to use in our work against misleading/harmful drugs. We thank you for this.

I also want to have in depth knowledge about companies’ pricing of drugs and how they are structured.

I visit to research information for patients and to learn more about direct to consumer drug advertising. As a patient in the USA, I’m often dismayed by drug advertising, especially the “soft advertising” like drug company sponsorship of patient groups. I am a member of National Women’s Health Network and Breast Cancer Action which are both outspoken about the latter.
I need to understand many aspects of these issues. Right now I am very interested in Celebrex as clinical studies are being mounted for people with my rare genetic condition. It is difficult to tell how much is hype and how much is hope since the media tends to utilize company press releases on “new scientific discoveries”.
It’s a thorny thicket to find my way through.

I was a medical student when I first joined. I am now a researcher in qualitative health, interested in continuing monitoring. Can’t afford subscription although would if could (I’m p/t and casual employed only). Need access to unbiased info - suggest student / underemployed / healthcare card full access free/$10pa? (Particularly for health professional students - future full subscribers if you get them early!!)

I work for a pharmaceutical company and am involved globally in the development and application of policies relating to ethical promotional standards. In such a role I need to understand the criticisms that are directed at the industry. If and when they are valid I can take appropriate action both within my own company and through various industry bodies with which I am associated.

It seems very relevant to have an “Amnesty International” irritating those who choose to market inappropriate claims. I regret the demeaning of Evidence Based Medicine by fiscal power’ and greed. I would suggest we might like to have a go at Blackmores [an Australian company selling “alternative” medicines] and various herbal peddlers too, whose methods and claims are equally as irritating as various drug company claims

My Honours Project is entitled “DTCA - from the perspectives of Patients, Doctors and Pharmacists”

Conclusions:
Supporting the cause of reducing harm from misleading promotion is clearly the main motivator for Paid Subscribers and is also important for Free Subscribers. Gaining information and learning about drug promotion are also important.

We plan to launch a new publication “AdWatch” this year. AdWatch will give subscribers a way to get involved like the paper MaLAM letters of the past. AdWatch will address many of the issues mentioned above. If you would like to get involved in the design or the ongoing production of AdWatch then your contribution will be most welcome. Please contact .(JavaScript must be enabled to view this email address)

All those who made additional comments are invited to contact .(JavaScript must be enabled to view this email address) for further discussion of ways to improve what we are doing and/or discussion of collaboration.

If you have any additional comments on reasons for subscribing to Healthy Skepticism be it Free or Paid, please make them in the box below (If you want a direct response please include your name and email address.):

3. Reasonable subscription fees

To be more effective Healthy Skepticism needs increased income. Subscriptions are our core source of income. We asked subscribers to indicate the dollar amount that was nearest to the sum they considered to be a reasonable annual subscription fee for Healthy Skepticism.

All amounts in AUD$ (Click here to convert $AUD to other currencies.)

Corporate
subscription

Ordinary
subscription

Concession
subscription
Paid Subscribers

Mean

$532

$123

$40

Median

$500

$100

$35

Mode

$1,000

$100

$50

Range

$200-1,000

$75-500

$25-100
Free Subscribers

Mean

$550

$81

$29

Median

$500

$75

$25

Mode

$500

$75

$25

Range

$100-1,000

$75-150

$25-50

Conclusions:
In the near future we will review subscription fees. We urge Free Subscribers to consider becoming financial supporters of Healthy Skepticism, as subscriptions are our main source of income. For more information see Your Options.

If you have any additional comments on subscription fees, please make them in the box below:

Healthy Skepticism International News

Healthy Skepticism 2003 Subscriber Survey: Report Part A

Comments

Announcements