Healthy Skepticism Library item: 5258

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Publication type: news

Consumers, Corporate Social Responsibility and Drug Promotion : Branding the Cure
Consumers International 2006 Jun 6
http://www.consumersinternational.org/Templates/Internal.asp?NodeID=95352&int1stParentNodeID=89650&int2ndParentNodeID=95352

Notes:

Ralph Fagotter’s Comments

For the full report of this detailed examination of pharmaceutical promotion go to – http://www.consumersinternational.org/Templates/Internal.asp?NodeID=95357&int1stParentNodeID=89650&int2ndParentNodeID=95352
and click on ‘Full Rpeort’

Full text:

Branding the Cure

A consumer perspective on Corporate Social Responsibility,
Drug Promotion and the Pharmaceutical Industry in Europe

Executive Summary

The project
Why do consumers care about the corporate
ethics behind the medicines they consume?
Are the grand claims of responsible behaviour
asserted by the pharmaceutical giants genuine,
or another disappointing show of corporate savvy
in masking ethically questionable behaviour?

These are some of the questions Consumers
International (CI) and its consortium of partners
sought to address via the Media Network for
Corporate Social Responsibility (CSR) and
Sustainable Consumption (SC). Through this
project, initiated in 2005, CI and several of its
member organisations teamed up with the
International Consumer Research and Testing
organisation (ICRT) to investigate the validity of
industry claims about CSR in the context of drug
promotion. CI members examined drug promotion practices in the Czech Republic, Denmark,
Finland, Greece, Hungary, Portugal and Slovenia.

The project was financially supported by the
European Commission’s Directorate General for
Employment, Social Affairs & Equal Opportunities.

What does CSR mean for
consumers?
CSR includes business activities beyond profit
making, to protecting the environment and
workers, being ethical in business operations and
being involved in the local communities in which
companies work. It should be stressed that from
the consumer viewpoint, CSR refers to respect for
consumer rights through responsible company
behaviour, and not to philanthropy alone. Crosscutting operational aspects like transparency form
an important part of CSR policies as well.

CI believes that media reporting of CSR issues is
vital to consumer confidence in company claims
of socially responsible business practices. A large
part of public opinion on CSR is shaped by the
media, whether through positive or negative
portrayals of company behaviour. In addition,
phenomena such as ‘brand loyalty’ indicate
consumers are susceptible to having their
attitudes and behaviours shaped by the media.
This project harnesses the influential potential of
consumer media to sustain public dialogue on
CSR. In doing so, the project is an innovative


Branding the Cure

step in improving consumer engagement on
the issue of CSR.

The problem
Pharmaceutical companies are major stakeholders
in the global health agenda. In 2005 total global
pharmaceutical sales grew 7% at constant
exchange rates, to $602 billion.1 Virtually all
drugs used by patients reach markets through
promotion by a small number of corporations
who have a tremendous impact on global health.
Consumers have therefore identified drug
promotion as a priority CSR issue.

However, existing CSR reporting mechanisms
are extremely varied among companies, codes of
conduct are not thoroughly implemented and
enforced, and the information for consumers is
incomplete or inaccessible.

The case of drug promotion highlights an
emerging crisis of legitimacy for the concept of
CSR. If barriers to transparent and verifiable
information persist, the consumer movement –
like other stakeholders – will begin to lose faith in
the CSR dialogue. This potential outcome will be
a major roadblock to understanding the role of
CSR in addressing key global problems, especially
in the health sector.

The research
Specific issues covered in the project were:

• company transparency in reporting on
marketing budgets
• medical sales representatives visits to health
professionals and their distribution of free
drug samples
• gifts, payments and hospitality to health
professionals
• appropriate use of promotional materials
• direct-to-consumer advertising (DTCA)
• disease awareness campaigns
• sponsoring of patients’ groups
• competition
• post-marketing research.
The companies studied included: Abbott,
AstraZeneca, Admirall Prodesfarma, Bayer,
Boehringer-Ingelheim, Bristol-Myers Squibb,
GlaxoSmithKline, Johnson & Johnson) (J&J), Lilly
(Eli), Lundbeck, Menarini, Merck Sharp Dohme,
Novartis, Novo Nordisk, Nycomed, Orion Pharma,
Pfizer, Roche, Sanofi-Aventi, Schering AG,
Schering-Plough and Wyeth.2

Main findings
Limited transparency in reporting
CSR information

Evidence from the project shows limited
transparency among the companies studied. For
instance, Orion Pharma was the only company that
provided information on the specific composition
of its marketing budget. Similarly, data on staff
composition was only available for a handful of
companies. Only two companies, GlaxoSmithKline
and Novartis, report the number of confirmed
marketing code breaches and resulting sanctions.

New marketing tactics may not be to
consumers’ benefit

In Europe, EU legislation does not permit the
marketing of prescription drugs to consumers
directly. For prescription medication,
pharmaceutical companies are now using
alternate pressure points to doctors, such as
patient groups, medical students and pharmacists,
coupled with new tactics, particularly using
internet chat groups and drug or disease
information websites, to market their products.
There is generally little guidance for staff on the
ethical considerations that need to be respected
when using such forums for marketing.

Other techniques involve providing health and
illness information via pamphlets, magazine
articles etc, without the company actually


Executive summary

promoting a specific product directly to the
consumer or health practitioner. This type of
‘nice-and friendly’ marketing is often disguised
as corporate social responsibility, and has been
shown to create a subtle need among consumers
to demand drugs for the diseases on which
information is provided.

Breaches of regulations and CSR codes
occur with regular frequency showing weak
industry self-regulation

Large numbers of serious, recent and repeated
breaches of marketing codes were found,
especially regarding prescription drug advertising.
The current regulatory framework is clearly
insufficient to prevent systemic violations of
marketing regulations, and to ensure the highest
possible level of consumer protection.

Furthermore, the overall lack of documented
approval procedures for drug promotion is
conspicuous. Nineteen of the twenty companies
are obligated under the European Federation of
Pharmaceutical Industries (EFPIA) Code of Practice
on the Promotion of Medicines to clear all
promotional materials before they are released.
Despite these obligations however, only four
companies (AstraZeneca, Bristol-Myers Squibb,
Novartis, and Roche) describe clear corporate
procedures for the approval of all promotional
materials. Such examples show that industry
self-regulation of drug promotion is weak and is
generally inadequate to protect consumers
from potentially misleading claims.

Recommendations
CI asserts that all relevant stakeholders, but
particularly governments and the pharmaceutical
industry, must act immediately to address the
persistent roadblocks to consumer sensitive and
socially responsible drug promotion. Specifically,
collective action by consumer organisations,
government authorities, the EU and the
pharmaceutical industry is required to:

1) Develop uniform guidance and indicators
for CSR reporting on drug promotion
2) Ensure industry compliance with existing CSR
codes, norms and regulations

3) Bolster existing codes with stronger guidance
on drug promotion tactics involving the
internet, patient groups and disease
awareness campaigns

4) Implement alternatives to a pure self-regulation
framework for drug promotion
5) Dissolve veiled relationships between pharma

ceutical companies and health researchers.
The concluding chapter of the report
recommends further follow-up actions for key
stakeholders.

Global action
Consumers International (CI) will continue to
demand responsible corporate behaviour and
respect for consumer rights. This year, CI has
already used findings from this project to support
its international work in the areas of health and
corporate social responsibility.

International Organisation for
Standardisation (ISO) Meeting: Lisbon,
15-19 May, 2006

CI participated in this meeting to contribute to
the creation of the first global standard on Social
Responsibility (SR). Our work at the meeting
showed that consumer organisations would not
ignore industry pressure to restrict media access
to the ISO–SR process. Transparency in SR is a
major consumer concern and the media play a
key role in sensitising consumers to CSR issues.
Using our research on the pharmaceutical
industry, CI made clear why granting media
access would enhance the transparency of the
ISO–SR process.

World Health Assembly: Geneva,
22-27 May 2006

At this event, CI worked to generate support for
resolution EB117.R13 “Global Framework on


Branding the Cure

Essential Health R&D”, introduced by the
governments of Kenya and Brazil. The resolution
would create an intergovernmental working
group to draw up a strategy and an action plan
that would guide future work on innovation and
public health. CI’s briefing paper for the event
was based on our research on the pharmaceutical
industry. It stressed that if adopted, this timely
resolution will positively impact the rights of
consumers to make health choices that are not
biased by information gaps or corporate agendas.
Key civil society partners such as Health Action
International (HAI- Europe) and Médecins Sans
Frontières (MSF), and CI members including the
Consumer Project on Technology (CP Tech) were
also very supportive of the resolution. Ultimately,
the resolution was approved by the Assembly and
commits the 192 member states to making
research and development (R&D) of medicines
consistent with public interest needs a priority.

Additional project materials can be downloaded
from the CI website:
www.consumersinternational.org/pharma

These include:

• The full report Branding the Cure: A consumer
perspective on Corporate Social Responsibility,
Drug Promotion and the Pharmaceutical
Industry in Europe
• Press releases and briefing papers
• A technical report on the drug promotion
context in developing countries
• Background notes on drug promotion topics
such as the prevailing regulatory regime in
Europe, key CSR issues, what CSR means to
consumers and more
• Profiles of pharmaceutical companies
• Media articles on drug promotion published
by European consumer magazines.
Footnotes
1

Source: IMS Health: http://www.imshealth.com/ims/portal/front/articleC/0,
2777,6599_3665_77491316,00.html

2

In some cases, reliable comparative data for specific companies was not
publicly available. Where possible, such information gaps have been
noted in the accompanying reports.

To read the full report, please visit:
www.consumersinternational.org/pharma

Consumers International (CI) is a federation
of consumer organisations dedicated to the
protection and promotion of consumers’
interests worldwide through institution-
building, education, research and lobbying
of international decision-making bodies.
It was founded in 1960 as a non-profit
organisation, and currently has over 230
members in 113 countries.

Consumers International is registered
in the UK, Reg. No. 4337865.

For more information, comments
or ideas please contact us:
Tel: +44 20 7226 6663
Fax: +44 20 7352 0607
e-mail: consint@consint.org
Or visit our website:
www.consumersinternational.org

Consumers International is a not-for-profit
company limited by guaranteed
registered in England and Wales
(registration number 4337865).
Registered office: 24 Highbury Crescent,
London N5 1RX, UK