By: Jean Johnson for Reflux1Part One
It’s not news that the pharmaceutical industry has gone on a marketing offensive. Anyone watching the nightly broadcasts, evening sitcoms, or reading any number of mainstream magazines can tick off the latest and greatest pills almost without thinking.
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Greg Critser’s Generation Rx offers the following statistics regarding the effects of direct-to-consumer (DTC) advertising:
The industry now spends on the order of $3 billion on DTC advertising and sees $4.20 in return on every dollar invested in “driving patients to their doctor’s offices.”
In 1993, the average number of prescriptions filled per person per year was seven. In 2000 it was 11, and in 2001, 12.
In 1997, 17 percent of elders were on nine or more regular medications. By 2005, the size of the senior group taking this amount of medicine had grown to 27 percent. | |
It seems innocent enough: Businesses within a capitalistic system wanting to get the word out on new products. Not to worry, some might say. Doctors are there to ensure that you are not just being led down the garden path but really taking advantage of cutting-edge medicine.
Writer Greg Crister, author of “Fat Land,” states in another of his noteworthy books, “Generation Rx,” that the drug companies found the idea of direct to consumer (DTC) advertising unethical as late as 1982.
“[Direct to consumer] advertising would make [patients] extraordinarily susceptible to product promises,” wrote Charles Hagan, vice president and general counsel of American Home Products, in one of several letters to Congress on the subject. Hagan was joined by the head of Smith, Kline and French who stated that “advertising would have the objective of driving patients to their doctor’s office,” and the head of Abbott Laboratories who was concerned that patients might wind up with prescriptions “that may not be needed.”
Ironically, after several maverick drug companies started boosting sales with advertising and lawsuits ensued, issues of free speech arose to muddy the waters. Consequently, when the Food and Drug Administration was finally pushed to resolve the situation by formulating new regulations in 1997, the result was a liberalized policy that left the field open enough for the predictions of the early 1980s to become realities.
Indeed, as problems with pharmaceutical companies’ marketing strategies continue to surface around the globe, watchdog organizations have arisen to alert the public to potential conflicts of interest and the belief that ad campaigns can be more about promoting profits than promoting health.
Furthermore, physicians are only human and can thus be swayed by the persuasions of marketers. While the general practitioner Peter Mansfield, M.D. of Adelaide is the driving force behind Adwatch through his organization Healthy Skepticism, the American Association of Retired Persons (AARP) is not far behind the Australian physician.
“Educating consumers about options beyond heavily marketed drugs is a key step in helping people ask questions about generic and less expensive alternatives,” said Lois Aronstein, director of AARP New York, in a press release. The director said that was just one aspect of the current problem, however.
“We need to go further,” Aronstein added. “The public deserves to see how the drug industry influences what drugs are prescribed – and consumers deserve new ways to save money on their drugs.”
GERD, Zantac, and GlaxoSmithKline’s Dilemma
Trends in the world of acid reflux or gastroesophageal reflux disease (GERD) drugs have mirrored the sketch above.
It all started in the late 1980s when Zantac, the ulcer medicine responsible for a third of GlaxoSmithKline’s revenues, was poised to lose its edge to new and better ulcer medicines. According to Shannon Brownlee, a Schwartz Senior Fellow at the New American Foundation and author of a December 2005, Washington Monthly analysis titled ‘How Drug Companies Convince Americans They’re Sicker Than They Are,’ while Zantac was great at suppressing stomach acid in patients with ulcers, research developing at the time increasingly showed that the bacterium H. pylori, not excessive acid, was responsible for ulcers.
Thus, as new drugs focused on treating H. pylori became available, physicians took patients off medications like Zantac and prescribed those that focused on the bacterium. For Glaxo it was a ‘what to do?’ problem of major proportions because the company had not pursued drugs effective against the bacterium and thus were essentially left out of the market.
Worse, ulcers were widespread, but other conditions like GERD that might benefit from Zantac’s acid-fighting capabilities were not, Brownlee writes. While heartburn was pervasive, people tended to go the route of grandma and grandpa and either take a teaspoon of soda in a glass of water, get an over-the-counter remedy, or simply try to back away from the table a little earlier next time.
“What Glaxo needed to do was persuade people that ordinary heartburn was an early warning sign of GERD,” Brownlee observes. “So Glaxo and its marketing team set about popularizing GERD and its potentially dire consequences through a marketing technique that is now used routinely by drug makers, and which came to be known as ‘condition branding,’ or selling a disease along with a drug.”
Join us in Part Two when we explore this topic further...
