Healthy Skepticism Library item: 12082

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: Journal Article

Greene JA.
Pharmaceuticals and the Economy of Medical Knowledge
The Chronicle of Higher Education 2007 Nov 30; 54:(14):B12
http://web.archive.org/web/20071224163923/http://chronicle.com/subscribe/login?url=http%3A%2F%2Fchronicle.com%2Fweekly%2Fv54%2Fi14%2F14b01201.htm

Abstract:

Newspaper headlines over the past few months have documented the downfall of Avandia, a promising and widely prescribed drug for diabetes now linked to increased mortality from heart attacks. Roughly a million Americans were taking Avandia before the news of the side effects broke, and the public now wants to know why so many people were allowed to consume a potentially harmful compound for so long. Like Vioxx, Avandia has become a flash point in the public debate over the risks of new medications, the ability of the Food and Drug Administration to protect the rights of consumers, and the influence of the pharmaceutical industry on policy makers and physicians.

Avandia’s decline reminded me of a marketing meeting I was invited to attend in the mid-1990s for a similar antidiabetic drug that was then nearing its launch date. It was to be the first of its kind: Unlike older diabetes medicines that attempted to squeeze more and more insulin out of a patient’s failing pancreas, this novel category of compounds was thought to increase cellular receptivity to insulin already available in the bloodstream. The marketers – several of whom happened to have diabetes – were visibly excited. They were about to promote what they believed to be an innovation of vast public-health significance, with blockbuster sales potential.

That convergence of marketing and public-health goals also posed a challenge. How could the marketers best convey the importance of the drug to physicians, steeped as they were in an older model of diabetes therapy?

The solution, projected in a flurry of PowerPoint slides, was to promote the disease – or, rather, a new model of the disease that lent itself to the new treatment …