Here is a taste..
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Physicians and surgeons have most frequently been the targets of these marketing efforts since they are viewed as the customers, even though patients are the ultimate consumers of the drugs.
As an example of how influential the marketing of drugs can be, Petersen noted that in 2003, for the first time, more psychotropic drugs were prescribed to children than antibiotics and asthma medications in the United States. Petersen suggests that the mass drug marketing has transformed pediatrics from a specialty whose sole purpose was the diagnosis and treatment of physical illness, to a specialty that focuses on altering children’s undesired behavior by medicating them. Petersen describes a variety of ways in which drug manufacturers aggressively mass market their drugs to physicians and surgeons. The story she tells is a sad one. The following are among the strategies she discusses:
1. Ghost-written articles
Petersen details the prevalence of corporations that have been created to ghost-write articles for the medical literature, which portray new medications as being comparatively more advantageous than existing medications, safer for the patient and, as a result, an advancement in the treatment of disease or illness. These ghost-written articles invariably present the results of clinical trials in a manner that distort the drug’s potential advantages, while simultaneously minimizing potential short-term, long-term and even fatal complications. This is often accomplished by selecting clinical trials that appear to demonstrate the new medication’s advantages, while eliminating those clinical trials that do not support its efficacy and safety.
2. Marketing themes
Petersen describes classic Madison Avenue marketing approaches by drug companies to promote their medications much in the same way that non-medical commercial products are marketed to consumers. The drug companies create a marketing theme and relentlessly promote that theme, creating sometimes false, and often dangerous, impressions about their newer and profitable medications.
As an example, Petersen goes into great detail about the marketing of narcotic painkillers. These painkillers were formally thought of as appropriate for cancer patients, but not appropriate for the generalized treatment of chronic pain. The theme of the marketing efforts was, and continues to be, that the dangers of narcotic painkillers have been overstated and that patients are needlessly suffering because of the “myth” of drug dependence or addiction. One company in particular flew health care professionals to resorts like Boca Raton, Fla. and Scottsdale, Ariz. “…where they were wined and dined and trained as speakers to spread the word that painkillers like OxyContin were safe.” As Peterson noted, “For thousands of Americans, this proved untrue.”
3. Wining and dining physicians and surgeons
Petersen documents that drug companies fastidiously collect information on the prescription patterns of physicians and surgeons by collecting pharmaceutical information. By collecting data on their prescription habits, drug companies can identify the physicians to target in their effort to reward those who prescribe their medications, as well as influence those who do not. Petersen describes the direct financial rewards provided to physicians and surgeons which have included trips, meals and direct cash payments. As Petersen noted, “Doctors have continued taking the loot, despite studies showing that even gifts as small as a pen could imbue them with the sense that they owe the pharmaceutical company a favor, a quandary that could be quickly solved by writing more prescriptions.”
4. Compensating physicians and surgeons as speakers and/or consultants
One method of rewarding physicians who frequently prescribe a company’s medications to their patients is by compensating them as speakers for the company. Petersen documents that, “A marketing firm called Thompson Physician World said in a 2002 brochure that it had signed up more than 20,000 physicians to speak on behalf of the drug industry. These doctors, Physician World stated, would ‘become critical lynchpins in product positioning.’” The speaker fees are also a reward for the use and promotion of a company’s drugs.
5. Drug representatives as a sales force
Although theoretically drug representatives are supposed to provide objective information, Petersen leaves little doubt that they are highly trained sales personnel. Their function is to persuade physicians and surgeons to increase sales volume by persuading the medical profession to prescribe newer and more expensive drugs to patients, even though most of these drugs are variations that offer little more than older medications. A secondary function of the sales representative is to assuage concerns physicians have when there are reports of potentially serious adverse consequences to drugs that have been heavily marketed to physicians and surgeons. The sales reps receive training in assuaging physician concerns related to adverse drug effects and in effective promotion of the drugs in the face of reports of these adverse outcomes."
http://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/{0e6d669f-418d-41ed-ab98-13294b19ffa5}/pushing-drugs-pharmaceutical-industry-and-physician-relationships-explored
