Healthy Skepticism Library item: 2885

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

Silverman M, Lee PR.
Pills, profits & politics
University of California Press 1976;

Abstract:

There is a growing fear that they major evil of excessive drug promotion may not be the hundreds of millions of dollars involved each year, but its effect in leading to excessive, irrational prescribing. In 1971 the industry spent 20% of its sales dollar on promotion versus 9% on research. The chapter covers issues such as: the extent of promotion; the reliability of promotion; sales representatives; journal advertisements; the role of the Food and Drug Administration in regulating promotion; the reliance of medical journals on advertising revenue and how that has influenced JAMA (Journal of the American Medical Association); throw-away medical journals; the quality of the information in the Physicians’ Desk Reference; gift giving; promotion through the mass media; and endorsements by leading physicians. In addition there are case studies of how Parke-Davis promoted Chloromycetin (chloramphenicol) and how Merck promoted Indocin (indomethacin).

Keywords:
*analysis/United States/promotion costs and volume/sales representatives/journal advertisements/controlled circulation journals/ad revenue/AMA/American Medical Association/JAMA/regulation of promotion/FDA/Food and Drug Administration/Physicians’ Desk Reference/commercial compendia/gift giving/quality of information/ promotion costs and volume/ Parke-Davis/ Merck/ Chloromycetin/Indocin/ATTITUDES REGARDING PROMOTION: MEDICAL JOURNALS/ETHICAL ISSUES IN PROMOTION: GIFT GIVING/EVALUATION OF PROMOTION: COMMERCIAL DRUG COMPENDIA/EVALUATION OF PROMOTION: CONTROLLED CIRCULATION JOURNALS AND JOURNAL SUPPLEMENTS/EVALUATION OF PROMOTION: DETAILING/EVALUATION OF PROMOTION: JOURNAL ADVERTISEMENTS/INFLUENCE OF PROMOTION: JOURNALISTS/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/PROMOTION AS A SOURCE OF INFORMATION: DOCTORS/PROMOTION DISGUISED: APPOINTMENTS AND RETAINERS/PROMOTION DISGUISED: PRESS CONFERENCES AND PRESS COVERAGE/PROMOTIONAL TECHNIQUES: ENDORSEMENTS/REGULATION, CODES, GUIDELINES: DIRECT GOVERNMENT REGULATION/VOLUME OF AND EXPENDITURE ON PROMOTION

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909