Healthy Skepticism Library item: 1475

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: news

Adams P.
A dose of healthy suspicion
The Australian 2003 Nov 8

Full text:

Scepticism is healthy. Far more than jogging, meditating or bran eating, it is conducive to mental, political, scientific and religious wellbeing.

Whereas cynicism – something frequently confused with scepticism – is not simply unhealthy but frequently malignant.

Today, however, I want to talk about an organisation called Healthy Skepticism (sic). I’ve had fleeting meetings with its founder, Dr Peter Mansfield, in hotel foyers and airports, and was immensely impressed with both the bloke and his cause.

Peter reminded me of the young Ralph Nader, first encountered when living in a Washington boarding house, conducting his campaigns from the pay phone in the hall. This dogged, determined one-man band took on Detroit – and won.

Nader can claim much of the credit for improved chassis design, seatbelts and airbags. Now Mansfield is taking on the formidable pharmaceutical companies – and if he and his tiny band of volunteers are successful, the world and we will be the better for it.

It all began during Mansfield’s final year as a medical student in 1982.

He’ d undertaken an elective in Bangladesh and was disturbed to see pharmaceutical companies promoting grossly inappropriate drugs – including anabolic steroids for malnourished children – to those who could least afford them.

Horror stories abound of the “pharmas” dumping inappropriate products on the developing world. It’s almost as appalling as their reluctance to provide life-saving drugs to the desperate – witness the recent brawling over AIDS treatments for Africa. In Australia, thanks to a far higher level of regulation and sophistication, problems with pharmaceutical companies are more subtle. Nonetheless, they occur and have to be confronted.

You’ll have seen the government advertising campaign in which an amiable GP asks us to help save money for the Pharmaceutical Benefits Scheme (PBS).

It’ s grown almost fourfold, from $1.18 billion in 1989 to $4.19 billion in 2002. According to Fortune 500, pharmaceutical industry profits constituted 18.5 per cent of revenue in 2002 – whereas other “top ten” performers ranged from 6.4 per cent to 13.5 per cent.

Inspired by the methods of Amnesty International, Mansfield established the Medical Lobby for Appropriate Marketing. Though minuscule, MaLAM managed to recruit subscribers in more than 30 countries, encouraging them to write to drug companies to ask a very embarrassing question. Was there scientific evidence to support this or that promotional claim?

In the 1960s, the US automotive industry did not realise for quite some time that, far from dealing with a well-heeled organisation, in Ralph Nader they were fighting one bloke with a pay phone. Similarly, the drug companies must have gained the impression that MaLAM was a big outfit when, in fact, its “international HQ” was the corner of a dining room in a small mobile home.

But now, with its name change to Healthy Skepticism, it’s growing very quickly indeed.

Appalled by the mass marketing of medicines and by the way the pharmaceutical companies manipulate the medical profession, Peter Mansfield tells me that 35 per cent of a pharmaceutical company’s budget goes on marketing – far, far more than is spent on research and development.

Since 1995, US brand-name drug companies have cut the number of R&D employees by 2 per cent, while marketing employees have increased by 59 per cent. These days they outnumber those in R&D by two to one.

And it’s not just the scale of the marketing, but also the strategies employed. Over the years, it’s been alarming to see overworked GPs, and even specialists, pumped with propaganda that, all too often, they take on face value or faith. Moreover, they’ve been inundated with inducements that seem indistinguishable from bribes. There are those first-class tickets to first-class hotels for third-class conferences, and lavish giveaways aimed at keeping medicos’ pens scribbling on prescription pads.

And, increasingly, there are the campaigns directed at the public to ensure the patients apply pressure on the GPs. Prozac and Viagra are two of the better known cases, but hardly a week passes without TV programs such as A Current Affair or Today Tonight delivering a rapturous report on some new treatment.

But even their straight advertising often needs a prescription – “Take with a pinch of salt”. The claims are overstated, the side-effects frequently buried in the small print or entirely overlooked. And this is where Healthy Skepticism comes in. It points out that the problem is not drug companies per se, but rather the system that rewards them for increasing the sales of new and expensive drugs – often monopolies protected by patent – when, often, older and less expensive drugs are just as effective. This diverts resources from better-value-for-money therapies.

One of Healthy Skepticism’s initiatives is a new service called Adwatch.

It puts the advertisements up on its Web site, and then analyses the approach and the claims.

It asks the embarrassing questions and puts the alternative case. It is intended to educate not only the medical profession, but also the advertising agencies – and the ultimate consumers.

If you find this notion interesting, as I certainly did, you should check the Web site: www.healthyskepticism.org