Thu. Dec 1st, 2022
Big Pharma spends $20 billion every year on documents, $6 billion on drug ads

Talk to your doctor… It’s a common refrain at the end of any drug ad or disease awareness campaign. Apparently it seems a responsible suggestion. Talking to your own trusted doctor can help determine if a new drug is real is is right for you or if you may be suffering from an undiagnosed illness. You shouldn’t just take the word of the pharmaceutical company behind that drug ad or awareness campaign, naturally.

But the suggestion to see your doctor may not be as harmless as it seems. The drug company probably went to see your doctor first.

Of the nearly $30 billion that health companies now spend on medical marketing each year, about 68 percent (or about $20 billion) goes toward convincing doctors and other medical professionals — not consumers — of the benefits of prescription drugs. This is evident from an in-depth analysis published in JAMA this week. The study mapped out exactly how health companies convinced us to spend huge amounts of money on our care between 1997 and 2016. At that time, health companies went from $17.7 billion to $29.9 billion in medical marketing. Meanwhile, US health care spending reached $3.3 trillion in 2016, or 17.8 percent of GDP.

However, the finding that pharmaceutical companies spend most of their marketing oomph on charming doctors is not surprising. In 1997, according to the analysis, as much as 88 percent ($15.6 billion of their total $17.7 billion) of medical marketing went to leading physicians. And the way drug companies pursue doctors hasn’t changed much, either. They do this largely by sending sales reps to doctor’s offices for in-person visits, providing free drug samples and other swag, offering payments for speeches, food and drink, travel, and organizing illness education.

What’s new — and why this is a more obscure situation now — is the explosion of direct-to-consumer (DTC) marketing that comes with those one-two punch marketing efforts. DTC advertising has more than quadrupled in the time frame of the analysis. That is, the money spent on DTC — mainly TV commercials and glossy magazine ads — went from $2.1 billion in 1997 to $9.6 billion in 2016. And of that $9.6 billion was about $6. billion for marketing prescription drugs, the analysis found.

That increase in DTC advertising “increases the need for clinicians to help patients understand product claims, medical needs, costs, and non-medical alternatives,” said health policy experts Selena Ortiz of Pennsylvania State University and Meredith Rosenthal of Harvard. . In an accompanying editorial in JAMAThe couple notes that this increased reliance on doctors can be fraught with pitfalls, as doctors can be biased and misled by marketing, just like consumers, previous research has found. This “suggests that professionals may need further training or support to arbitrate in deceptive marketing,” they write.

Ultimately, “trust in doctors and healthcare facilities could be at stake if medical marketing … continues to grow unchecked,” they conclude.

spicy marketing

The authors of the analysis — Lisa Schwartz and Steven Woloshin, health policy experts at Dartmouth — point to a particularly worrisome practice of the “find-a-doctor” feature in some advertisements. These features “help consumers find prescribers, an approach that has raised ethical questions by creating a conflict of interest over whether prescribers serve patients or companies,” they write. As examples, they cite the websites of the weight-loss drug Contrave and the hypoactive sexual desire drug Addyi, which encourages potential patients to schedule telemedicine visits to “complete your doctor’s consultation from the privacy of your own home.”

Even without such obvious ties between physicians and companies, DTC marketing and awareness campaigns are clearly impacting patients and prescribing practices, note Schwartz and Woloshin. A 2005 study found that patients were more than twice as likely to receive a prescription for an antidepressant or an adjustment disorder drug if they just told their doctor, “I was watching this TV show about depression and was wondering if you thought a drug could help me” than if they didn’t say something like that (76 percent vs. 31 percent).

In addition, the authors point out that coordinated marketing campaigns are even more powerful, and the devastating opioid epidemic now sweeping the country is a prime example. In the 1990s, as drug representatives misled medical professionals about the abuse potential of Oxycontin and promoted off-label use of the powerful pain reliever, the drug’s maker, Purdue Pharma, launched aggressive awareness campaigns and pain education programs about opioid treatments for chronic, non-cancer pain. . Between 2000 and 2015, the number of opioid prescriptions and overdose deaths quadrupled. The Centers for Disease Control and Prevention now estimate that about 46 people die each day from prescription opioid overdoses.

Now that the risks were clear, Schwartz and Woloshin looked at the regulatory activities of the Food and Drug Administration and the Federal Trade Commission and the Attorneys General. They found a lackluster response to skyrocketing medical marketing across the board. In fact, the FDA’s Office of Prescription Drug Promotion, which regulates advertising materials for consumers and professionals, actually saw a decline in regulatory activity. While the number of entries increased from 34,182 in 1997 to 97,252 in 2016, offense letters fell from 156 to 11 in those respective years. The finding “suggests the possibility of less oversight,” the authors conclude, possibly because FDA reviewers “may be overwhelmed by the surge in promotional submissions.”

Overall, Schwartz and Woloshin conclude that, “despite the growth of marketing over the course of 20 years, regulatory oversight remains limited.”

JAMA2018. DOI: 10.1001/jama.2018.19320 (About DOIs).

By akfire1

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