7 Moynihan Drug promotion
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7 Moynihan Drug promotion Presentation Transcript

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