Mellman: The abuse of drug polling

PhRMA, the trade association of prescription drug companies, wrongly reinterpreted a poll showing overwhelming support for government negotiating drug prices, to suggest the survey found the opposite.

The problem is not just with PhRMA, however, it’s part of a much wider misunderstanding about interpreting poll data.

Sometimes responses should be interpreted quite literally and other times not literally at all. Sometimes polls mean exactly what they say, and sometimes they don’t.

Knowing which circumstances are which emerges from a combination of experience and being steeped in the science of survey research.

PhRMA’s recent “analysis” of public opinion data on negotiating drug costs presents a prime example of the problem.

First, a bit of background.

Full disclosure: My family and I benefit greatly from lifesaving prescription medication. And I’ve polled for PhRMA.

I recognize the research and development cycle required for drugs is costly, and I’d be a hypocrite if I didn’t acknowledge companies’ right to a reasonable profit from their investment.

However, because most other advanced economies control drug costs and the U.S. does not, we pay disproportionately high prices for pharmaceuticals.

Americans earn about 20 percent of the world’s income but supply two-thirds to three-quarters of drug company profits.

That’s because, according to a Rand study, we pay prices 3.44 times higher for the same branded medicines as consumers in other countries. 

One of the most widely supported proposals for reducing U.S. drug costs is “Allowing the government to negotiate with drug companies to get a lower price on prescription drugs that would apply to both Medicare and private insurance.”

Kaiser Family Foundation (KFF) polling found 88 percent favoring this approach in May, 83 percent in early October.

KFF’s great pollsters included another set of questions in May asking whether respondents would “favor or oppose allowing these negotiations if you heard that…” Inserted, following the “that,” were a couple of arguments from both sides, each tested individually.

So, for example, if people heard that “It could lead to less research and development of new drugs” or that “It could limit people’s access to newer prescription drugs” 65 percent said they would oppose negotiations.

Conversely, 90 percent would favor the proposal if they heard that “People could save money on their prescription drugs.”

PhRMA seized on the items suggesting 65 percent “opposition” to produce a memo alleging, “public polls have repeatedly demonstrated that support for government ‘negotiation’ evaporates once voters learn that these policies could result in restrictions in access to medicines or slow down innovation into new treatments for challenging conditions.”

While this is literally true, it is wholly wrong.

Respondents did say they’d oppose negotiating drug prices if they heard about these negative outcomes. But that’s not what the question or the responses mean.

What most voters hear in response to such questions is, “if I focus mainly on this statement, and if I end up believing it, would I still support the idea.”

While my report of what voters hear is somewhat speculative, we can be certain the results do not mean 65 percent will in fact oppose this idea if they heard it would lead to less R & D.

We can be sure because, in September, my firm asked the question.

We juxtaposed the arguments made by both sides in the KFF poll and then asked about the proposal using KFF’s original wording. 

Some people/other people say both individual patients and the U.S. government could save money on prescription drugs by letting the government negotiate with drug companies for cheaper prices, like other countries do.

Some people/Other people say if we allow the U.S. government to negotiate prices with drug companies, it will lead to less research and development of new drugs and limit patients’ access to new drugs.

The result? Seventy-one percent favor allowing negotiations, 29 percent oppose.

Interestingly, KFF used the same method themselves in early October, employing somewhat different arguments and found 83 percent in favor and 16 percent opposed.

Different questions preceding this one, different arguments, so different numbers, but the same clear conclusions.

First, voters overwhelmingly favor allowing the government to negotiate with drug companies for lower prices and PhRMA is just wrong in saying support “evaporates” in the face of their arguments.

Second, analysts who interpret any such poll questions literally, whether about issues or candidates, are equally likely to be wrong.

Mellman is president of The Mellman Group and has helped elect 30 U.S. senators, 12 governors and dozens of House members. Mellman served as pollster to Senate Democratic leaders for over 20 years, as president of the American Association of Political Consultants, and is president of Democratic Majority for Israel.