Healthy Skepticism Library item: 19523

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

Petersen M.
Pediatric book on breast-feeding stirs controversy
The New York Times 2002 Sep 18
http://www.nytimes.com/2002/09/18/business/media/18ADCO.html

Full text:

Some leading members of the American Academy of Pediatrics are expressing outrage that the group is allowing the maker of Similac infant formula to print its corporate logo on the cover of a special edition of the academy’s book on breast-feeding.

Members who helped write the book, “New Mother’s Guide to Breastfeeding,” said they were stunned to learn last month from people outside the academy that it had agreed to let the Ross Products unit of Abbott Laboratories , which makes Similac, buy the edition of the book with its name and a teddy bear logo on 300,000 copies.

The academy, whose members include 57,000 pediatricians and other pediatric specialists, has long recommended that most mothers breast-feed because of the myriad benefits over formula.

The group also has a written policy that discourages hospitals from partaking in one of the ways that Ross and other formula manufacturers market their products: providing a free package of formula and other items to mothers as they leave the hospital. Ross, which says it also wants to promote breast-feeding, is considering distributing the books in the promotional packages of free formula but has not made a final decision.

“For those of us who wrote the book, this is thievery,” said Dr. Lawrence M. Gartner, the former chairman of the University of Chicago’s pediatrics department and chairman of the academy’s executive committee on breast-feeding. “The impression that people have when they see the book is that Ross is a supporter. This corrupts efforts to promote breast-feeding.” Dr. Gartner and other members are asking the academy to develop a policy to ensure that commercial logos are never again placed on its books and other educational materials. He said that he and some other members had grown increasingly concerned about the influence that corporations had on the academy.

“We’d like it to be clean,” Dr. Gartner said of the academy. “Any hint that it is not diminishes its credibility.”

But Dr. Joe M. Sanders, the academy’s executive director, said Dr. Gartner’s request was not feasible because the academy could not pay for all the educational materials it wants to produce without corporate support.

“Ten years ago, this probably would not have been acceptable,” Dr. Sanders added, “but things change.”

Indeed other medical groups have entered into deals with corporations — some that drew intense criticism from members and the public.

For example, in 1997, the American Medical Association agreed that Sunbeam could affix the group’s name to products ranging from blood pressure monitors to heating pads. After the association backed off in the face of criticism, it settled a breach-of-contract lawsuit filed by Sunbeam for nearly $10 million.

Dr. Sanders said the pediatrics group often solicited corporate contributions after it had decided to embark on an educational project.

For example, McNeil, a division of Johnson & Johnson , agreed to pay for 50,000 copies of a book the academy is developing called the “Complete and Authoritative Guide to Attention-Deficit Hyperactivity Disorder.” McNeil, which sells Concerta, a new treatment for the disorder, will give the books, imprinted with its name, to doctors, according to an academy document.

Ross has also paid to buy copies of another book, “Your Baby’s First Year.” That book was also imprinted with the Ross name as well as the name of its product, Similac.

The companies had no influence on the content of any of the books, Dr. Sanders said.

“This is standard in the industry,” he said. For example, pharmaceutical companies often pay to put their names on medical textbooks, he said, and then distribute them to students.

“That is how I got to know the major pharmaceutical companies,” Dr. Sanders said. “They gave me some medical textbooks. Obviously the advertising works.”

At the suggestion of Dr. Gartner, the academy’s directors plan to discuss the issue on Friday, Dr. Sanders said.

Neither Dr. Sanders nor Ross would disclose how much the company paid for the 300,000 books, which have a retail price of $13.95 each.

But publishing experts say that such large purchasers of books can expect to get a discount of 50 percent to 60 percent. At a 60 percent discount, Ross would have paid roughly $1.7 million for the books.

Dr. Sanders said the academy had made a profit of no more than $500,000 on the purchase.

“Our goal was not to make money,” he said, “but to get it into the hands of mothers.”

Dr. Sanders said he disagreed with Dr. Gartner’s contention that the group was violating its policy of promoting breast-feeding by letting Ross distribute the books with its corporate logo.

Mary Beth Arensberg, a spokeswoman for Ross, said the company bought the books as part of its effort to educate parents about the importance of breast-feeding. “We agree with the academy that breast-feeding is the gold standard for infants,” she said.

The company wants to provide the best information possible, Ms. Arensberg said, which is why it bought the academy’s new book.

The marketing of infant formula to mothers has been an issue for some time. In 1981, after marketing scandals in developing nations, the World Health Organization adopted a code banning formula advertising and free distribution by doctors and in hospitals.

In the United States, advocates have tried to persuade hospitals to stop distributing the gift packs of formula they receive from manufacturers. So far, only small numbers of hospitals have agreed.

Americans bought $2.5 billion of infant formula last year, according to ACNielsen.

This is not the first time the academy has been criticized for taking money from Ross and other formula manufacturers.

In the early 1990’s, Nestlé — the Swiss company that makes Carnation Good Start infant formula — sued the academy, Ross and Bristol-Myers Squibb , the maker of Enfamil, the other leading brand of formula. Nestlé accused them of conspiring to keep it at a disadvantage. The suit said the pediatric group had accepted millions of dollars from the major formula manufacturers, including helping to pay for the group’s headquarters in Elk Grove, Ill.

Nestlé did not prevail in that lawsuit, but the major formula makers have paid tens of millions of dollars over the years to settle accusations made in other lawsuits that they had tried to keep Nestlé and other manufacturers out of the market.

Last year, Ross, McNeil and Johnson & Johnson were the top three corporate supporters of the academy’s $65 million operating budget, Dr. Sanders said, each giving $500,000 or more. He declined to be more specific about how much the companies had contributed.

ome leading members of the American Academy of Pediatrics are expressing outrage that the group is allowing the maker of Similac infant formula to print its corporate logo on the cover of a special edition of the academy’s book on breast-feeding.

Members who helped write the book, “New Mother’s Guide to Breastfeeding,” said they were stunned to learn last month from people outside the academy that it had agreed to let the Ross Products unit of Abbott Laboratories , which makes Similac, buy the edition of the book with its name and a teddy bear logo on 300,000 copies.

The academy, whose members include 57,000 pediatricians and other pediatric specialists, has long recommended that most mothers breast-feed because of the myriad benefits over formula.

The group also has a written policy that discourages hospitals from partaking in one of the ways that Ross and other formula manufacturers market their products: providing a free package of formula and other items to mothers as they leave the hospital. Ross, which says it also wants to promote breast-feeding, is considering distributing the books in the promotional packages of free formula but has not made a final decision.

“For those of us who wrote the book, this is thievery,” said Dr. Lawrence M. Gartner, the former chairman of the University of Chicago’s pediatrics department and chairman of the academy’s executive committee on breast-feeding. “The impression that people have when they see the book is that Ross is a supporter. This corrupts efforts to promote breast-feeding.” Dr. Gartner and other members are asking the academy to develop a policy to ensure that commercial logos are never again placed on its books and other educational materials. He said that he and some other members had grown increasingly concerned about the influence that corporations had on the academy.

“We’d like it to be clean,” Dr. Gartner said of the academy. “Any hint that it is not diminishes its credibility.”

But Dr. Joe M. Sanders, the academy’s executive director, said Dr. Gartner’s request was not feasible because the academy could not pay for all the educational materials it wants to produce without corporate support.

“Ten years ago, this probably would not have been acceptable,” Dr. Sanders added, “but things change.”

Indeed other medical groups have entered into deals with corporations — some that drew intense criticism from members and the public.

For example, in 1997, the American Medical Association agreed that Sunbeam could affix the group’s name to products ranging from blood pressure monitors to heating pads. After the association backed off in the face of criticism, it settled a breach-of-contract lawsuit filed by Sunbeam for nearly $10 million.

Dr. Sanders said the pediatrics group often solicited corporate contributions after it had decided to embark on an educational project.

For example, McNeil, a division of Johnson & Johnson , agreed to pay for 50,000 copies of a book the academy is developing called the “Complete and Authoritative Guide to Attention-Deficit Hyperactivity Disorder.” McNeil, which sells Concerta, a new treatment for the disorder, will give the books, imprinted with its name, to doctors, according to an academy document.

Ross has also paid to buy copies of another book, “Your Baby’s First Year.” That book was also imprinted with the Ross name as well as the name of its product, Similac.

The companies had no influence on the content of any of the books, Dr. Sanders said.

“This is standard in the industry,” he said. For example, pharmaceutical companies often pay to put their names on medical textbooks, he said, and then distribute them to students.

“That is how I got to know the major pharmaceutical companies,” Dr. Sanders said. “They gave me some medical textbooks. Obviously the advertising works.”

At the suggestion of Dr. Gartner, the academy’s directors plan to discuss the issue on Friday, Dr. Sanders said.

Neither Dr. Sanders nor Ross would disclose how much the company paid for the 300,000 books, which have a retail price of $13.95 each.

But publishing experts say that such large purchasers of books can expect to get a discount of 50 percent to 60 percent. At a 60 percent discount, Ross would have paid roughly $1.7 million for the books.

Dr. Sanders said the academy had made a profit of no more than $500,000 on the purchase.

“Our goal was not to make money,” he said, “but to get it into the hands of mothers.”

Dr. Sanders said he disagreed with Dr. Gartner’s contention that the group was violating its policy of promoting breast-feeding by letting Ross distribute the books with its corporate logo.

Mary Beth Arensberg, a spokeswoman for Ross, said the company bought the books as part of its effort to educate parents about the importance of breast-feeding. “We agree with the academy that breast-feeding is the gold standard for infants,” she said.

The company wants to provide the best information possible, Ms. Arensberg said, which is why it bought the academy’s new book.

The marketing of infant formula to mothers has been an issue for some time. In 1981, after marketing scandals in developing nations, the World Health Organization adopted a code banning formula advertising and free distribution by doctors and in hospitals.

In the United States, advocates have tried to persuade hospitals to stop distributing the gift packs of formula they receive from manufacturers. So far, only small numbers of hospitals have agreed.

Americans bought $2.5 billion of infant formula last year, according to ACNielsen.

This is not the first time the academy has been criticized for taking money from Ross and other formula manufacturers.

In the early 1990’s, Nestlé — the Swiss company that makes Carnation Good Start infant formula — sued the academy, Ross and Bristol-Myers Squibb , the maker of Enfamil, the other leading brand of formula. Nestlé accused them of conspiring to keep it at a disadvantage. The suit said the pediatric group had accepted millions of dollars from the major formula manufacturers, including helping to pay for the group’s headquarters in Elk Grove, Ill.

Nestlé did not prevail in that lawsuit, but the major formula makers have paid tens of millions of dollars over the years to settle accusations made in other lawsuits that they had tried to keep Nestlé and other manufacturers out of the market.

Last year, Ross, McNeil and Johnson & Johnson were the top three corporate supporters of the academy’s $65 million operating budget, Dr. Sanders said, each giving $500,000 or more. He declined to be more specific about how much the companies had contributed.