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Healthy Skepticism Library item: 4692

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: book

Drake D.
Making medicine making money
Kansas City: Andrews and McMeel 1993


Abstract:

Chapter 2 (pages 25-45) discusses promotion. There are 45000 sales representatives in the United States and the average American doctor sees 2-3 detailers per week. Sales representatives combined with advertising are more effective in associating a specific drug with a medical problem than journal advertising alone. Companies in the United States collectively spend more than $10 billion a year on promotion, with about $3 billion going to detailers and $500 million for journal advertisements. Sales representatives can dramatically increase overall sales of drugs. Companies also use other promotional techniques including: ghost writing of articles; paying physicians favourable to the product to lecture on it; paying doctors to take part in postmarketing studies that are really designed to get the doctor to prescribe more of the product. Companies also fund continuing medical education as a form of promotion and create consumer demand by issuing press releases and flooding media outlets with packaged stories and television productions. Drug representatives also target hospital formulary committees trying to get their companies’ products placed in the formulary. The Food and Drug Administration was forced to back down on regulations that would have ensured that companies could not disguise promotional efforts in supposedly independent programs, such as continuing medical education.

Keywords:
*analysis/United States/promotion costs and volume/sales representatives/journal advertisements/ghost writing/continuing medical education/CME/corporate funding/Food and Drug Administration/FDA/postmarketing research/ seeding studies/ conference speakers/ sponsored symposia & conferences/ press conferences and releases/ETHICAL ISSUES IN PROMOTION: GIFT GIVING/ETHICAL ISSUES IN PROMOTION: PAYMENT FOR MEALS, ACCOMODATION, TRAVEL, ENTERTAINMENT/EVALUATION OF PROMOTION: DETAILING/EVALUATION OF PROMOTION: JOURNAL ADVERTISEMENTS/INFLUENCE OF PROMOTION: FORMULARY INCLUSION/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/PROMOTION AS A SOURCE OF INFORMATION: DOCTORS/PROMOTION BY THIRD PARTIES: HEALTH PROFESSIONAL ORGANIZATIONS/PROMOTION DISGUISED: CONFERENCES AND MEETINGS/PROMOTION DISGUISED: POSTMARKETING RESEARCH/PROMOTION DISGUISED: PRESS CONFERENCES AND PRESS COVERAGE/PROMOTION DISGUISED: SUPPORT FOR CME/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