Over the last couple blogs we have spoken about different how science and medicine sometimes provides misleading information to the public. Many times, this misinformation is because of financial or personal gains.
Now I want to talk about the marketing aspect of medicine. This is a very important facet of the medical business, and it may surprise you how this has progressed over the years.
As you know, I am the author of "Legend of the Mystic Knights", a fantasy novel, based in a medieval world. It was my research about the middle ages that I located several instances of medical marketing.
During the medieval period, the plague ran rampant through Europe. There were several “preventions” for the plague sold by conmen throughout Europe. One of these was to sell flowers, which were to be placed in your pockets, and this would ward off the plague.
As a result of this “flower cure” people continued to drop dead of the plague, and then their bodies were burned in mass pyres. From this tragedy the nursery rhyme was created, “A ring around my rosie, a pocket full of posies, ashes, ashes we all fall down.”
Recently, there has been some historical research that has tried to discredit the above explanation for the nursery rhyme. Even if it is not true, it does make my point about drug marketing.
There have been numerous changes in the way pharmaceutical companies market their drugs. Once, it was directed solely to the doctors themselves, informing the medical professional of how their drugs work, and how effective it is. They continue this process, (see below) but now the marketing is more geared toward the patients, this is called Direct-to-Consumer Advertising.
This type of marketing has grown over the last several decades. In 1997, the Food and Drug Administration (FDA) eased regulations dealing with pharmaceutical companies and Direct-to-Consumer ads. This opened a flood gate of advertisements geared toward patients who suffer from a condition, and those who don’t.
There are several arguments for and against this type of advertisements. The pro, is that it educated consumers about the products which are available to them. The con is that patients are now going into their doctor’s office demanding drugs they saw on TV, and the physician is no longer making the medical decisions.
Although both arguments are compelling, the increase in the Direct-to-Consumer ads is remarkable. The majority of drug companies now spend more on the marking of their drug then they did on the development and research of it. Consider Johnson and Johnson, in 2013 they spent 8.2 billion dollars for research and development. As high of a number this may seem, consider that they spent 17.5 billion on marketing over the same period.
Even though pharmaceutical companies now use Direct-to-Consumer advertising, they have not forgotten the consumer’s doctors. Direct Marketing is where these companies’ representatives visit or advertise directly to doctors. These reps often provide meals to the doctor’s office while they are pitching their drugs.
There are other ways the representative pitches the product, including giving the doctors free samples to give to their patients. They may also invite doctors to educational and promotional meetings to support their products. Some of these are conducted at restaurants where these companies provide free meals to the physicians.
To know the scope of Direct Marketing, in the United States, there is 1 pharmaceutical representative for every 7.9 doctors. On average, a doctor in the United States sees 20 patients a day.
For doctors who play ball with the pharmaceutical companies, can become tools for these companies. The drug companies identify these doctors and refer to them doctors as “thought leaders”. The medical reputation of these thought leaders help establish the validity of the drugs. Furthermore, the companies rely on them to promote their products to other doctors. These “though leaders” are invited to more conferences and promotional meetings.
The reason why these drug companies can establish if a doctor is prescribing a drug is made by them, is because these companies have access to the sales at your local pharmacist. They can access this information as part of a regulation that was supposed to protect your privacy.
The Health Insurance Portability and Accountability Act (HIPAA) were conceived as a protection, so your personal medical information was not released, however, this has turned into a database used by pharmaceutical companies.
When you go into a pharmacy to obtain a prescription, you were given a HIPAA form, which informs you of your rights and release of information about you. This HIPAA form also includes information that health care providers, health plans, and their business associates or contractors can use your information without your consent for purposes of treatment or payment.
What does this mean? The pharmaceutical companies end up knowing which medicine your doctor proscribed. So if your doctor changes your prescription, and this drug is made by another company, the pharmaceutical company that produced the original drug will know about it.
Although just knowing if their drugs are being prescribed does not seem harmful, consider the relationship that these pharmaceutical reps have with their doctors. This is a rep who brings free drug samples, and free meals to the doctor’s office. Having the doctor’s assistants, receptionists, records keeper, etc., getting a free meal so they do not have to pay for lunch is almost like giving them raises, that is a large pressure for the doctor to be under.
There are many other ways the pharmaceutical companies peddle their drugs. Marketing is a large business, and these companies are making huge profits. Americans spent 329.29 BILLION dollars on prescription drugs in 2013.
A final note: With money comes political power, the Supreme Court Ruled that the FDA has authority over drug companies, which means they are now exempt from any lawsuit. So basically, if you buy a drug and it makes you sick or even it kills a family member because this drug manufacturer made a mistake (or even did it on purpose), you cannot sue them.
Next time: Its Renaissance Festival Time