Are the staggering amounts spent by drug companies on marketing justified by their innovation in drug development? Not according to a Policy Forum in PLoS Medicine which has stimulated a great deal of debate across blogs and news sites over the past couple of weeks.
The analysis by Marc-Andre Gagnon and Joel Lexchin dispels the image promoted by the pharmaceutical industry that it is “research-driven, innovative, and life-saving.” The data they obtained from IMS (a market research company that surveys pharmaceutical companies for information on drug promotion) and CAM (who survey doctors instead of firms) demonstrates the extent to which the industry is actually driven by marketing. They find that for 2004 nearly twice as much was spent on promotional activities than on research and development.
That’s US $61,000 spent on promotion per physician in the United States, as Howard Brody of the University of Texas Medical Branch exclaimed in his blog before reflecting upon the lack of transparency in the industry. As ABC Television News reported, Gagnon and Lexchin suggest that there are other promotional revenues that won’t have been captured by the market research data. (These include the ghostwriting of articles in medical journals by drug company employees, the subject of a PLoS Medicine essay last September).
Concern about direct to consumer advertising of drugs was prominent in the Consumerist – an influential consumer affairs blog – which clocked up over 50 comments in response to the paper. In Canada, CBC News made reference to the practice known as detailing (drug reps visiting doctors to persuade them to promote specific drugs, as described in a previous PLoS Medicine Policy Forum). However, Gagnon and Lexchin go on to say that the extent of detailing could be underestimated by the IMS data which obtains its figures direct from the industry. Readers of the Sci Guy blog of the Houston Chronicle expressed concern about how physicians can be compromised by gifts and drug samples, prompting a post from No Free Lunch, an organization dedicated to convincing physicians that such gifts represent a conflict of interest.
A statement from PhRMA (Pharmaceutical Research and Manufacturers of America (PhRMA) – quoting its own figures to counter the analysis – was in the Peterborough Examiner. (For those of you in the UK, that’s Peterborough, Ontario not Peterborough, Cambridgeshire).
Fittingly, for authors who took the opportunity of publishing a French translation of the abstract with their the study, media coverage also came in Le Figaro. For those of you adept in other languages, you can read the coverage in Italy (La Repubblica), Argentina (Clarin) and Germany (Der Spiegel).