Drug companies “make and sell a lot of extremely effective, safe and valuable medicines, which extend life and reduce suff...
Drug companies “make and sell a lot of extremely effective, safe and valuable medicines, which extend life and reduce suff...
<ul><li>While many drugs can  </li></ul><ul><li>reduce suffering and extend lives,  </li></ul><ul><li>drug promotion can b...
<ul><li>“Creating the need”   </li></ul><ul><li>is one of the pharmaceutical industries </li></ul><ul><li>key promotional ...
 
How curious! The drugs and the disease  are made by the same people!
Potential Conflict  <ul><li>Public Interest:  rational use of medicines </li></ul><ul><li>Pharma Interest:  maximum use of...
Problems with pharma promotion <ul><li>Drug promotion:   can lead to inappropriate use,   costly and dangerous </li></ul><...
Drug promotion examples  <ul><li>Hormone replacement therapy slightly increases risk heart attacks, strokes, cancer  (long...
Disease promotion examples <ul><li>Osteoporosis:   risk factor made into disease </li></ul><ul><li>Social Anxiety Disorder...
Disease promotion examples <ul><li>Osteoporosis:   risk factor as disease </li></ul><ul><li>1994: WHO defines osteoporosis...
Disease promotion examples <ul><li>Social Anxiety Disorder (SAD):  widening boundaries of disease </li></ul><ul><li>PR fir...
Disease promotion examples <ul><li>Female Sexual Dysfunction (FSD):  creating new disease </li></ul><ul><li>Key medical me...
Promotion Targets Three Groups <ul><li>Professionals </li></ul><ul><li>Patients  </li></ul><ul><li>Public </li></ul>
Promotion Targets Three Groups <ul><li>The spin </li></ul><ul><li>Professionals:  drug companies “educate” doctors </li></...
Promotion Targets Three Groups <ul><li>The reality </li></ul><ul><li>Professionals:  education becomes skewed to latest dr...
What to do about drug promotion? <ul><li>Discover </li></ul><ul><li>Disclose  </li></ul><ul><li>Disentangle </li></ul>
What to do about drug promotion? <ul><li>Discover:  investigations, commissions, inquiries into corrupt relationships </li...
Drug companies “make and sell a lot of extremely effective, safe and valuable medicines, which extend life and reduce suff...
<ul><li>More references for presentation </li></ul><ul><li>Moynihan R,  Too Much Medicine? , ABC Books, Sydney, 1998 </li>...
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7 Moynihan Drug promotion

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7 Moynihan Drug promotion

  1. 1. Drug companies “make and sell a lot of extremely effective, safe and valuable medicines, which extend life and reduce suffering.” Medicines Australia, Annual Report 2002
  2. 2. Drug companies “make and sell a lot of extremely effective, safe and valuable medicines, which extend life and reduce suffering.” Medicines Australia, Annual Report 2002 Ray Moynihan, Australian Financial Review
  3. 3. <ul><li>While many drugs can </li></ul><ul><li>reduce suffering and extend lives, </li></ul><ul><li>drug promotion can be poisonous </li></ul>
  4. 4. <ul><li>“Creating the need” </li></ul><ul><li>is one of the pharmaceutical industries </li></ul><ul><li>key promotional strategies </li></ul>
  5. 6. How curious! The drugs and the disease are made by the same people!
  6. 7. Potential Conflict <ul><li>Public Interest: rational use of medicines </li></ul><ul><li>Pharma Interest: maximum use of medicines </li></ul>
  7. 8. Problems with pharma promotion <ul><li>Drug promotion: can lead to inappropriate use, costly and dangerous </li></ul><ul><li>Disease promotion: ordinary life becomes disease, healthy people turned into patients </li></ul>
  8. 9. Drug promotion examples <ul><li>Hormone replacement therapy slightly increases risk heart attacks, strokes, cancer (long term use) Rossouw JE, et al, JAMA, 2002, 288, 321-33 </li></ul><ul><li>Anti-arthritis drugs (cox-2s) increase risk heart attacks </li></ul><ul><li> (not necessarily a class effect) Chen LC, Ashcroft DM, Pharmacoepidemiol Drug Saf., 2007, 16:762-72 </li></ul><ul><li>Anti-depressants associated with slightly increased risk of suicidal behavior Healy D, Aldred G, Int. Rev. Psychiatry, 2005, 7, 163-72 </li></ul>
  9. 10. Disease promotion examples <ul><li>Osteoporosis: risk factor made into disease </li></ul><ul><li>Social Anxiety Disorder: widening boundaries of disease </li></ul><ul><li>Female Sexual Dysfunction: creating new disease </li></ul>
  10. 11. Disease promotion examples <ul><li>Osteoporosis: risk factor as disease </li></ul><ul><li>1994: WHO defines osteoporosis = 30% of older woman suffer “disease” </li></ul><ul><li>2007: “pre-osteoporosis” = 50% of older women, 200 million have “condition” </li></ul><ul><li>International Osteoporosis Foundation activities sponsored by companies </li></ul><ul><li>Alonso P, Guyatt G, Moynihan R, BMJ, 2007, (in press) </li></ul>
  11. 12. Disease promotion examples <ul><li>Social Anxiety Disorder (SAD): widening boundaries of disease </li></ul><ul><li>PR firm Cohn & Wolfe “raise awareness” about disease before Paxil approved </li></ul><ul><li>Cohn & Wolfe specialise in “cultivating the marketplace prior to approval” </li></ul><ul><li>“ Information” campaign says “1 in 8” suffer SAD- shyness as a symptom of disease </li></ul><ul><li>GSK funded PR campaign explicit aim to boost sales of GSK’s Paxil </li></ul><ul><li>Cohn & Wolfe won PR industry awards for campaign – “astro-turfing” </li></ul>
  12. 13. Disease promotion examples <ul><li>Female Sexual Dysfunction (FSD): creating new disease </li></ul><ul><li>Key medical meetings to define FSD sponsored by drug companies </li></ul><ul><li>18 of 19 authors of new FSD definition disclose financial ties to companies </li></ul><ul><li>Company linked researchers claims 43% of women suffer FSD </li></ul><ul><li>Moynihan R, Making of a disease, BMJ, 2003,326, 45-7 </li></ul>
  13. 14. Promotion Targets Three Groups <ul><li>Professionals </li></ul><ul><li>Patients </li></ul><ul><li>Public </li></ul>
  14. 15. Promotion Targets Three Groups <ul><li>The spin </li></ul><ul><li>Professionals: drug companies “educate” doctors </li></ul><ul><li>Patients: drug companies “partner” with patients </li></ul><ul><li>Public: drug companies “inform” the public </li></ul>
  15. 16. Promotion Targets Three Groups <ul><li>The reality </li></ul><ul><li>Professionals: education becomes skewed to latest drugs </li></ul><ul><li>Patients: patient groups become advocates for drugs </li></ul><ul><li>Public: misleading advertising disguised as information </li></ul>
  16. 17. What to do about drug promotion? <ul><li>Discover </li></ul><ul><li>Disclose </li></ul><ul><li>Disentangle </li></ul>
  17. 18. What to do about drug promotion? <ul><li>Discover: investigations, commissions, inquiries into corrupt relationships </li></ul><ul><li>Disclose: comprehensive and mandatory disclosure of ties & sponsorship </li></ul><ul><li>Disentangle: criminalize bribes, reduce sponsorship, more independent voices </li></ul>
  18. 19. Drug companies “make and sell a lot of extremely effective, safe and valuable medicines, which extend life and reduce suffering.” Medicines Australia, Annual Report 2002 Ray Moynihan, Australian Financial Review
  19. 20. <ul><li>More references for presentation </li></ul><ul><li>Moynihan R, Too Much Medicine? , ABC Books, Sydney, 1998 </li></ul><ul><li>Ray Moynihan & Alan Cassels, Selling Sickness , Allen & Unwin, 2005 (translated into more than a dozen languages) </li></ul><ul><li>www.healthyskepticism.org </li></ul>
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