New Medical Procedure: Destroying Nerves to Lower Blood Pressure (Part 2, The Hype)

by Heidi Stevenson

27 December 2009

When a new drug or procedure is developed, the single most important factor is selling it to the public. When profits are the primary focus of healthcare, it can't be any other way. So, when a startup company has tons of money and is closely allied with a medical company that's highly successful, then the hype for its product starts early—before it's even out of testing.

That's how Herceptin was forced on the NHS (National Health Service) in the UK. While NICE (National Institute for Health and Clinical Excellence) wisely saw it as an extremely expensive and mostly ineffectual breast cancer drug, public pressure forced its approval at the expense of other drugs shown to have greater benefit at signficantly lower cost.

A new product that destroys nerves in an effort to control high blood pressure is another case in point. The product, Symplicity Catheter System, by Ardian, which is supposed to cure high blood pressure, has only been through it's first clinical trial—and that hasn't been too effective. A vaunted placebo-controlled trial has yet to be done. But the hype has already started.

Why else has just one single procedure in the UK been done—with one major newspaper being informed about it? That's what has happened with a procedure to "cure" high blood pressure by partially destroying nerves, as discussed in New Medical Procedure: Destroying Nerves to Lower Blood Pressure (Part 1, The Trial).

Let's examine how the hype is whipping up public support for a procedure that can, at best, be described as questionable.

The Website

In today's world, the first thing one must do is set up a website. Make sure it's attractive and appeals to both of the target audiences: the doctors who want to make money and the patients who want to be fixed. To this end, Ardian, the manufacturer of the Symplicity Catheter System, has produced one typical of such products. The product isn't even available to either the medical profession or the public, but it's already being pushed.

Ardian's site has press releases extolling its product's merits, links to other websites that have covered the product, information aimed at doctors, information aimed at potential patients, and even a media kit for the press. It includes information that reporters can use to educate themselves about the subject (biased towards their product, of course), a nice glossary of terms, a really cool video showing how their product works, a "fact sheet" full of information about the company's viability, the efficacy of their product, simply-worded information about the condition it cures, and beautiful images that the press is free to use at no charge, one of which is shown here. How generous!

In other words, they make it easy to do articles about their product, and of course, spin the information in a most positive light.

Press Releases

Nowadays, the media like nothing better than to be given stories ready-to-print. That's what press releases are. Ardian provides exactly that. If you have any doubts about that, then simply Google "Compelling results from the first clinical study evaluating an innovative catheter-based treatment for chronic hypertension were presented today". These are the first words of an early Ardian press release. You'll see that many sites have reproduced the press release as if they'd written it themselves.

The "Exclusive Story"

A single popular news site—one that's generally considered to be respectable—is offered the opportunity to be the first to cover the wonderful advance that their product makes in medicine. In the case of Ardian's Symplicity Catheter System, The UK's Telegraph got the chance to be the only newspaper with the inside track on the first implementation of their product in the country. Wow! Zounds! What a scoop! Never mind that there's only been a single trial and no placebo-controlled trials have yet been done. Getting the chance to scoop all the other papers assures that sympathetic—and unquestioning—reporting will be done.

It worked to a charm in this case. The Telegraph produced two stories, one on how wonderful the procedure is and the other on how it works.^(1,2) Of course, as might be expected, the information provided is mostly available on their website, and the rest is quotations from people Ardian selected.

From the cardiologist who performed the surgery, Professor Rothman:

Patients will be able to walk into the hospital and walk out again the same day.

This relatively trivial procedure has the potential to make a serious improvement to the quality of life for the patient.

It is very efficient and can lower the blood pressure enough to reduce stroke mortality by 50 per cent.

From the Chief Medical Officer of Ardian:

For the first time we can think of a cure for hypertension.

From David Collier, Senior Clinical Trials Fellow at the Biomedical Research Unit at Queen Mary University London:

This procedure can bring patients within the normal blood pressure range and may enable some to come off their medication. It is the equivalent of them taking two types of drugs. They could be considered cured, at least in the medium-term and we hope long-term.

Wow! Who wouldn't believe that the final, ultimate, perfect soluction for high blood pressure has been found?

Patient Groups

The profitability of the Symplicity Catheter System may make this marketing technique unneeded. Thus far, there's no sign of patient groups pressing for its application. Ardian is likely aware that doctors will jump onboard fast enough to make a Heparin-like campaign necessary. Nonetheless, I'll cover this marketing method to assure that readers are aware.

In cases where the doctors themselves can't make significant profits from a medical product, the ultimate pressure groups must be elicited: patient organizations. They are, of course, composed of people who are affected by the condition that the product purportedly cures. As in the case of Heparin—a drug with extremely limited applicability and even less effectiveness, patients groups were either created or plied with money to sell the product.

By pumping money into apparently grassroots groups, the press is elicited into reporting on how money prevents unfortunate patients from receiving the treatment that might save their lives. The treatment in question, of course, is the one that supports those "grassroots" efforts.

The sad case of Anne Marie Rogers, a British woman suffering from breast cancer, is a case in point. She was successful in leading the charge to require the NHS to provide Herceptin to victims of breast cancer, and she's hailed as a hero for her efforts. Ultimately, her struggles benefitted Genetech, the maker of Herceptin, not herself. She died three years after gaining NHS approval for the drug.

She had been convinced by Genentech that their product would cure her breast cancer—she believed that she was fighting a battle for other women, not just herself. The reality was far different. She died—but her campaign lives on.

The Goal

The goal of any modern medical procedure or product is to convince the public that it's an easy cure and doctors that it's a quick way to make a buck or quid. Thus far, Ardian has done a brilliant job of pushing its Symplicity Catheter System for high blood pressure. To this end, the media is malipulated by offering easy stories to reproduce, or the opportunity to be exclusive purveyors of some new and exciting story. Doctors are convinced that there's a ton of easy money to be made by using their product. Patients are convinced that there's an easy fix for their problem.

The goal is money—as much as possible. Therefore, common conditions are targeted. That's why Symplicity Catheter System was created—because there are huge numbers of people who've been diagnosed with hypertension. That's an enormous, and largely trapped, market.