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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
Drug companies “make and sell a lot of extremely effective, safe and valuable
medicines, which extend life and reduce suffering.”
Medicines Australia, Annual Report 2002Ray Moynihan, Australian Financial Review
While many drugs can reduce suffering and extend lives, drug promotion can be poisonous
“Creating the need” is one of the pharmaceutical industries
key promotional strategies
How curious! The drugs and the disease are made by the same people!
Potential Conflict
Public Interest: rational use of medicines
Pharma Interest: maximum use of medicines
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
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
Disease promotion examples
Osteoporosis: risk factor made into disease
Social Anxiety Disorder: widening boundaries of disease
Female Sexual Dysfunction: creating new disease
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)
Disease promotion examplesSocial 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”
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
Promotion Targets Three Groups
Professionals
Patients
Public
Promotion Targets Three Groups
The spin
Professionals: drug companies “educate” doctors
Patients: drug companies “partner” with patients
Public: drug companies “inform” the public
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
What to do about drug promotion?
Discover
Disclose
Disentangle
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
Drug companies “make and sell a lot of extremely effective, safe and valuable
medicines, which extend life and reduce suffering.”
Medicines Australia, Annual Report 2002Ray Moynihan, Australian Financial Review
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