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Healthy Skepticism Library item: 6986

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: report

de Laat E, Windmeijer F, Douven R
How does pharmaceutical marketing influence doctors' prescribing behaviour?
2002 Mar
http://www.cpb.nl/nl/news/2002_11.html


Abstract:

The Netherlands Bureau for Economic Policy Analysis (Centraal Planbureau – CPB) conducted a study of Dutch prescribing practices and marketing data for 11 common drugs between 1994 and 1999. It found that medical doctors were heavily influenced by marketing activities of pharmaceutical companies. Pharmaceutical companies spent 20% or more of their revenues on marketing, more than in any other industry. An increase of 10% in marketing efforts resulted in a 3% increase in demand. Approximately 40% of this increase is at the expense of demand for other products; the remainder comes from an overall increase in demand for drugs. Medical doctors value drugs higher and prescribe them more frequently the more marketing information they receive on them. Pharmaceutical marketing activities reduce price elasticity in prescribing behaviour: this reduction was statistically significant. Marketing activities specifically focused on doctors, e.g. detailing and direct promotional texts, reduce this price elasticity to nearly zero. The CPB argues that in a sub-market, e.g. that of anti-hypertensives, antacids, and anti-depressants, where marketing activities increase, prescribing behaviour of doctors becomes less cost-conscious. This is unfavourable for welfare in a nation, as it provides pharmaceutical companies with extra market power, a power that may manifest itself in price increases or absence of price decreases. The CPB proposed stricter rules, including bans on ‘training’ activities sponsored by the industry, and banning pharmaceutical company grants for participation of physicians in post-marketing research as a way to promote specific drugs.

 

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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