Pleading Ignorant on Drug Marketing

January 13th, 2010. By Kristine B

Last week, Pleading Ignorance briefly looked at what “off-label” means when talking about drugs. This week, I thought I’d take a slightly more in-depth look at drug marketing—starting with how pharmaceutical companies market drugs to doctors. You sort of already know how drugs are marketed to consumers (i.e., YOU) because you see the ads. But pharmaceutical marketing to physicians is a little less transparent. So let’s talk about it.

Drug companies have two target audiences that they market their drugs to: the doctors, which makes sense because the doctors are the ones who write the prescriptions; and you, the consumer. That’s why, more and more frequently, you see ads on tv telling you to talk to your doctor about a certain drug. How often do you watch tv and see some sort of ad that starts off “Do you feel down?” or “Are you in pain?” Drug companies know that if you said “yes” to those questions you might just go in to your doctor and ask about the drugs they’re advertising. But it’s not so easy to do that with the doctors.

Marketing to doctors is definitely different from marketing to consumers (I can’t imagine too many doctors would respond to a tv ad that says, “Does your patient feel down?”). Marketing to doctors is more about scientific information. That’s all the somewhat boring stuff—found on the monograph for the drug—that lists things like “Indications” or “Adverse Events” or “Co-morbitidy,” stuff that the scientists understand but we may not. There are also reports about clinical studies that have been done, and a host of marketing materials that can be presented to the doctors in a neat little package.

To get information to the doctors, pharmaceutical companies sponsor conferences or keynote speeches at which their product is discussed—often by an expert in the field, one whose opinion is highly respected by other doctors. The companies also send sales reps out to hospitals and doctors’ offices with packets of information and, possibly, samples of the drugs. The idea is to give doctors important information about the drug, so the doctor is more likely to write a prescription for Drug A than for Drug B.

Sometimes, however, drug companies (allegedly) use less than honest tactics when marketing to doctors. I’m going to say again—ALLEGEDLY—drug companies do this. Although there have been lawsuits filed, many have been settled without the drug company admitting wrongdoing.

Off-label Marketing

I referred to off-label use of drugs in last week’s Pleading Ignorance. As I pointed out, prescribing drugs off-label (that is, for uses the drug isn’t approved for) isn’t illegal. But, it’s illegal for a drug company to market a drug for off-label use. Essentially, if a drug is approved to treat arthritis, the drug company can’t market the drug as a treatment for pneumonia, even if the drug company honestly believes the drug is an effective cure for pneumonia. If the FDA hasn’t approved a drug for a specific use, it simply cannot be marketed for that use.

So, the drug company can only market the drug for arthritis (“Do you have patients with sore joints?” is how I imagine the marketing might begin.) Even with this being illegal, companies have been accused of marketing their drugs for off-label purposes.

Of course, even in promoting drugs to doctors, drug companies are accused of exaggerating the benefits of a drug or downplaying the risks. And doctors don’t have time to conduct the research themselves, so they rely on the data provided by the drug companies and their reps. So if that data is at all misrepresented, the doctors are left uninformed about the real side effects of a drug or its actual effectiveness.

Medical Journals

So, if drug companies aren’t properly marketing their drugs or giving the correct information to doctors, maybe doctors can read those fancy journals—you know, the ones where after you do google search for information on something, you find yourself on some page reading one paragraph called an “Extract” and if you want the “Full Text” you have to cough up a subscription fee . Those have some good information, right?

True, they do have excellent information. However, drug companies have also been accused of having articles ghostwritten for those journals. Ghostwriting is when one person (in this case, an official from the drug company) writes the article or study but someone else’s name (in this case, a doctor) is put on the article or study as the author. The information appears solid—after all, it looks as though a doctor wrote the article—but in reality, it’s been written—or paid for—by someone with a vested interest in having the drug appear safe and effective.

According to Bloomberg.com (June 12, 2009), Eli Lilly (Zyprexa) had officials write studies and then put doctors’ names on the articles.  However, Lilly is not the only company alleged to have done this. Merck & Co. (Vioxx), Pfizer Inc. (Bextra and Celebrex), GlaxoSmithKline (Paxil), and Wyeth (fen-phen) have also been accused of having articles ghostwritten.

These ghostwritten articles tend to focus on favorable aspects of the drug while downplaying the risks. Doctors who read these articles, or who hear about them through the news, have no reason to think the information given is in any way skewed, so they trust the data. Then, they prescribe the drug to you, thinking it is safe and effective to treat whatever condition you have.

Truly, not all pharmaceutical companies engage in ghostwriting practices, but it can and does happen—so you should be aware of it.

Next time in Pleading Ignorance: How drug companies target you in their marketing.

Tags: Drug Marketing, Pharmaceutical Marketing, Pleading Ignorance

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