Healthy Skepticism Library item: 17334

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Electronic Source

Carlat D
WebMD's Big Lie
The Carlat Psychiatry Blog 2010 Feb 28
http://carlatpsychiatry.blogspot.com/2010/02/webmds-big-lie.html

Full text:

In order to provide quality web-based health content, you need money. The question is how you choose to make that money. WebMD, like many web sites, makes money from advertising, but it consistently goes several steps further, allowing its content to be transformed into one long stream of stealth advertising.

The incredibly successful company was just caught red-handed by Senator Chuck Grassley, who saw a WebMD television commercial encouraging viewers to log on to the site in order to take a depression screening test. When Grassley navigated over to the test, he found that it was funded by Eli Lilly-information that was apparently omitted from the TV commercial.

What’s the big deal? At first blush, this looks like business as usual. I read through the test, which appears to simply go through the DSM-4 criteria for depression, one at a time. Nor is the test actually written by Lilly. In fact, at the top of the page is the statement “This content is selected and controlled by WebMD’s editorial staff and is funded by Lilly USA.” So it would appear that Lilly paid WebMD staff to encourage people to discover whether they have depression, and to seek appropriate treatment from their doctors. Yes, some of these patients might end up on Lilly’s antidepressant Cymbalta, but others would be prescribed competing antidepressants. Looked at this way, this isn’t particularly deceptive or nefarious. In fact, it might be interpreted as a public health service—enhance awareness of depression, and everybody benefits.

But of course this story isn’t quite that benign. Let’s take a closer look at Web MD’s depression screening test. DSM-4 lists nine possible symptoms of depression, yet WebMD’s test lists ten. Here is WebMD’s extra item:

“I’m having frequent headaches, stomach problems, muscle pain, or back problems.
Yes
No”

Now, nobody would insist that the nine DSM criteria are the be-all and end-all of depression. Depressed patients often experience problems that are not specifically included in DSM-4’s list. These include symptoms and behaviors like lowered sex drive, irritable mood, excessive use of drugs or alcohol, and, yes, various physical aches and pains. There are many more. So why, out of the dozens of possible depressive symptoms not listed in DSM-4, did WebMD decide to ask about one, and only one, in particular: aches and pains?

Because Lilly markets Cymbalta as the “go to” antidepressant for patients who have both depression and physical pain. This is not really a “depression screening test” at all. Instead, it is a “Cymbalta-requester” screening test.

WebMD is telling the public a big lie. The say that “this content is selected and controlled by WebMD’s editorial staff” when in fact the crucial aches and pains questions was selected by Eli Lilly’s marketing team to encourage patients to ask their doctors for Cymbalta.

The company’s blatantly deceptive techniques are particularly ironic given that WebMD’s CEO, Wayne Gattinela, likes to talk up “transparency” in interviews about his company. Clearly, WebMD would never allow transparency to get in the way of an Eli Lilly payday.