Pharma: Still Chasing Skirts
As someone who spent ten years inside the pharmaceutical industry, I can tell you one thing for sure: Big Pharma goes where the money is. And the money is with the ladies.
Chicks matter
Although women are certainly not the only targets of drug ads, winning the female audience is critical to the success of any given drug. Women are more proactive about their health, more likely to "talk to their doctor", more likely to encourage their husbands to seek medical treatment (than their husband is to seek it himself), and more likely to manage the healthcare for the entire family. It is just darned good business for pharma to set their sights on the ladies. But what is good for business -- explosive prescription sales of new drugs -- is not necessarily good for public health.
Newer is not better, Dorothy
The vast majority of the drug ads we see are for the newest and most expensive drugs available. These drugs are exceptionally profitable for the industry, but newer is definitely not better when it comes to patient safety. Few people realize that "new" means that the drug has been tried in a smaller number of patients and for a shorter period of time than drugs that have been around for years. Despite these limited studies, new meds quickly reach millions of consumers through very effective direct-to-consumer advertising.
It is often not until these drugs are consumed by the masses that potential problems (or public awareness of problems) in the form of dangerous and deadly side effects begin to arise. Patients who take "new" drugs become unknowing guinea pigs.
Dorothy Hamill spinning around the rink and driving millions to their docs for Vioxx served as a testament to this scenario. But even the Vioxx fallout has not stopped Merck's machine as they now push marketing and mandates for Gardasil, their HPV vaccine.
Reeling 'em in
Women need to know that they are being studied, targeted, and manipulated by very effective advertising that has little to do with good science. The ads and the target markets are heavily researched by internal marketing departments, branding experts and advertising companies.
In order to effectively drive sales with the important female demographic, companies first identify which issues in life women are most concerned and/or insecure about. They then develop their entire marketing campaign around those issues rather than the specific science of the drug. Big bucks go into finding the emotional hot button for any given pill or medical problem. The majority of ads feature sexy, smiling, happy people -- walking by the lake, rolling around with their children, or on a fun/hot date. We all want a little piece of that, don't we? Pharma knows how to play off of women's deepest insecurities and our biggest dreams...and it works.
The marketing of hormone replacement therapy (HRT) was a perfect example. The industry capitalized on the vanity and emotional fears of women -- resulting in billions of dollars in prescription revenue for the pharmaceutical industry and questionable efficacy and damaging side effects to women worldwide.
And yet...the beat goes on
We as women are marching into our doctors' offices in record numbers demanding the latest and greatest pills we see on television. These ads paint a beautiful Norman Rockwell life on the screen. They do a wonderful job of convincing us that we too can be this happy, this sexy, this beautiful if only we would take this pill. The pharmaceutical companies are not selling us a drug; they are selling us a lifestyle.
The most severe drawbacks occur when the commercials result in us medicalizing our problems. Pharma has done a masterful job of creating illness and reasons for us to take more pills. Shyness, road rage, and even menstruation can now be treated with a drug. Thus we have begun demanding drugs we often don't need and that could have serious potential for harm and sometimes even death.
The other drawback is that these ads create a false sense of security. We subconsciously feel we can be a little more reckless with our nutrition, or activity level, or even sleep because there is now a pill to take care of all of the issues that result from not taking good care of ourselves.
I am a reasonable person. I am a mom and wife who understands that in the right context, we need prescription medication to be available. That said, I am in the minority of consumers who knows both sides of the issue. And that knowledge can be our most powerful tool when it comes to effectively managing our own health or the health of our families.
Get enough of us gals knowing and we can potentially force the hand of pharma to concentrate on producing truly superior, safer, and more cost-effective drugs rather than producing effective marketing campaigns. Because they can't sell what we won't buy.
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From the CRS report for congress, titled “Pharmaceutical Research and Development: A Description and Analysis of the Process”:
“Second, the calculation of those pharmaceutical R&D costs that have been reported all contain a factor accounting for the cost of capital. This cost element accounts for the opportunity cost of money invested in the R&D process. In other words, the funds used for R&D could have been used for other investments (opportunities) that will yield a return. Those ‘lost’ opportunities are accounted for by including the forgone returns as part of the cost of performing R&D. Including such costs is a standard accounting practice used by all of industry in computing R&D costs. In the OTA estimate, opportunity costs constitute about 65% of the total R&D cost for a typical drug.”
“It seems clear that the pharmaceutical R&D cost estimates reported above understate the true cost by not including federally funded R&D that contributed to the ultimate development of the drug.”
“These figures suggest that the cost of pharmaceutical R&D to the industry for a typical drug would increase significantly if it had to absorb all of the costs that now directly support drug development but which are funded by NIH.”
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Big Pharma is all about business. Being responsible to the bottom line and their share holders is a clear conflict of interest with the responsibility to their consumers. Pharmaceutical drugs are the 3rd leading cause of death in this country, after heart disease and cancer. If the FDA or other agency would do their job, direct-to-consumer advertising would be illegal. And the junk science studies that are used to promote the drugs to physicians would be scrutinized. What is the real answer? Make Pharmaceutical non-profit. As long as billions of dollars are at stake, our medical system will be driven by greed, not by safe and effective medicine. Take away all third party payment, insurance or government, and the system becomes transparent. And much more affordable. Medicine should be a profession of compassion and care--not a get rich quickly ticket for MD's or drug peddlers. There is simply too much at stake to continue as the system now exists. The cost is too high--unless you put profits before people.
Not only does pharma go after females in the population they also try to figure out how to target female doctors. A doctor can sign up to be part of surveys responding to pharm ads in medical journals, and they do look at how female doctors respond to these ads. Make no mistake, the number one budget for pharms is advertising, not R&D.
Well, it makes perfect sense that Big Pharma would market heavily toward women. Why wouldn't they? ALL major retail oriented corporations in America market heavily toward women. That's because women are the primary purchasers (shoppers) in the nation. No other demographic group comes close to the purchasing power of women. This simple fact drives the retail economy, so much so, that the consumer drives the creation of products and services. That is why there is a never-ending, dizzying array of endless food choices, color preferences, health and beauty products, clothing, entertainment choices, television programming, etc.... just name it.... and it was created solely because women are the purchasers in our society. If men were the primary purchasers of household goods and products, then our modern society would be very different.
i thought the headline referred to the use of women to pimp pharmaceuticals to doctors; that ruthlessness is a true tragedy. My 2 friends who hustled legal drug were beautiful and intelligent, and knew nothing about the consequence of their products; they learned the script, who to talk to, and how to over come objections...and they made tons of money. I wish articles and reporting of this nature had more prominence in media..
Of course, now they have no job stability. People who worked as reps for years are fearing for their jobs. With the continual mergers, none of them are safe.
I'm glad my job is at least a little more secure. People always need health care....of course that's no guarantee, but....
Curious. Not one mention of the FDA. Why doesn't someone analyze why medicines are more expensive by investigating the symbiotic relationship forced on pharmaceutical companies to kow-tow to the governmental agency that forces these companies and scientists to jump through hoops to get an "approvable" for a new medicine?
Please consider:
1. Pharmaceutical companies contribute millions of dollars of free medicines to individuals. Compassionate Care. Medicines to those with AIDS in Africa, to indigent individuals in America, to humanitarian crises throughout the world. Who acknowledges this contribution? Patients who have benefited and survived.
2. If you're so outraged by pharmaceutical companies, why are you taking or asking for prescription medicines? Please take good care of yourself. And when you're a hospital patient, you may request no medicines there too.
3. If anger is to be vented at pharmaceutical companies, then consider the need for these medicines in your own life and in the lives of others. Appreciate a society based on capitalism and competition. Reconcile that these medicines cost an extraordinary amount of monies to discover, cost an extraordinary amount of time to be approved after years of trials and supplication to the FDA , and cost an extraordinary amount of effort to market and meet FDA regulations (i.e., the latest commercial for "Yaz" beginning with: The FDA has asked us to clarify....).
4. Name the medicines "NOT discovered or created" by an American pharmaceutical company.
A bit of perspective and critical thought. Be well.
ginger root
garlic
arnica
eucalyptus
passionflower
osha
crucifixion thorn
mirabilis
apple mint
mesquite
etc.
etc.
“4. Name the medicines "NOT discovered or created" by an American pharmaceutical company.”
Sure no problem….This drug would ultimately become the number one selling drug in the United States for over 10 years. Manufactured by Hoffman La Roche, a Swiss Company, Valium (diazepam) is still to this day one of the most widely prescribed medication in the world……
The pharmacy scam in this country works like this: Hospitals have closed formularies. This forces Big Pharma to give prices that are pennies on the dollar to what retail, with an open formulary, has to pay for them. Hospitals then turn around and charge by the dose at thousands of percent markup helping to drive up total healthcare costs. Closed Hospital formularies also influence the prescribing habits of the MD’s who practice there and Big Pharma knows this. Big Pharma makes up for the preferential pricing to hospitals by cost shifting to retail to make their money. The absolute best contracts given to the biggest retail contracts already have a ton of cost shifting in them. While being on a med in a hospital will just be for days (at a low preferential price), outpatient cost is for a lifetime….
Direct marketing to patients is a problem. They just don't have the background to cope with the messages. They generally can't filter the claims, or weigh the alternatives. And they shouldn't be expected to.
I'm a doctor in private practice. It's still possible for me to autocratically operate as I see fit. So patient interests get placed higher than their requests.
The ones that can tell I'm on their side, stay. The ones that can't, leave.
1) My mother was a physician and would have been proud to know you.
She spent hours poring over the PDR to find the best medication for a particular patient's combination of medical malady and personal issues that could form a good or bad drug experience. She always took into account any allergies or tendencies a patient had and would not prescribe a new drug just because it was new. It had to be better, genuinely better not just a tenth of a percent better, than what it purportedly replaced. I remember her saying that many times the costlier newer drugs weren't enough better to warrant her prescribing them for her patients to have to pay for.
Toward the end of their lives in a progressive community, she prescribed a psychiatric drug for my stepdad that she thought would be best for his dementia, telling the nursing home that 1 tablet morning and evening should suffice, but 1 could be added at lunchtime if deemed necessary. Instead of adding the 1 tablet, the house doc, a GP (my mother was a psychiatrist), prescribed something different entirely, taking him off what my mother had prescribed. The reaction was extremely marked, and he was unmanageable during medical appointments the first day on the new drug. He was like a totally different person.
2) I called the GP's office that evening and spoke with his partner since he wanted to be able to talk with the house doc. I reminded him that in PA, at least at that time, GP's were not allowed to prescribe psychiatric drugs and that the house doc had not made an easy change from one drug to the other. When I assured him that a psychiatrist had prescribed the first, the order was reversed the nexr morning with the additional original tablet at lunch time, and my stepdad settled back down.
That same nursing home, run by a religious group, also allowed the GP to bill Medicare for a visit by my folks every week. In the 5 months my mother was in the nursing home area before she died, she saw the house doc twice. They also paid no attention whatsoever to her oncologist's request for care to a massive bruise on her head caused by a fall and subsequent open wound. and I did the care in the evening when I visited after being told by a disgusted night nurse what to do. They also would not alter her diet al all to include high-calorie foods needed because her tumor was as the lower end of the esophagus and made eating painful. So I made high calorie snacks for her. They also pushed Ensure pudding, which had milk in it (Ensure liquid did not), and that irritated her lactose intolerance.
3) I had to be really vigilant during her final illness and get teary-eyed even now (she died in 1990) thinking of the difference in the care she gave others and the care, or lack thereof, that she received.
Speaking of marketing your practice... Physician, David Zahaluk has written a great book titled, "The Ultimate Practice Building Book" which may help Physicians market themselves in an appealing and also teaches Physicians how to wear the two hats of being a physician and running a good successful business.
http://www.ultimatepracticebuilder.com/
One of President Obama's proposals for health care reform is the establishment of a central clearing house for information on the efficacy of various treatments, including pharmaceuticals. In other words, a place where doctors can see the relative benefits of one tablet over another and over placebo, all based on scientific investigation; a place where doctors can see whether treating a patient one way produces better results than another way; a place where doctors can get the most up-to-date and complete information on scientific studies and clinical trials.
Currently, many doctors get most of their "information" through sales calls from pharmaceutical reps. Their patients may well get whatever yesterday's rep, often armed with a short skirt and lunch, hyped. And patients come in asking for some tablet to cure some disease described in a magazine ad - some doctors comply.
Some Republicans, of course, have attacked the proposed central repository of information as Democrats telling doctors how patients can be treated. Nothing could be further from the truth - the agency is a resource and the treating doctors make the decisions with their patients, of course. Be sure that pharma lobbyists are gearing up to keep the industry is the best source of (mis)information.
Any healthcare reform must include a repository of the best information gleaned from both government (NIH, National Cancer Institute, FDA, CDC, etc.) and industry. I have written my representatives to urge them to include it in the reform package.
See Kathleen Slattery-Moschkau's Profile
This issue has multiple layers. As I mentioned in a previous comment below, docs are not only getting their info from sales reps but from required continuing medical education that is funded by pharma more than 75% of the time.
Also, the studies that doctors rely on are paid for by pharma , then written up by ghost writers with financial ties to the industry and ultimately published in journals that rely on pharma advertising. (See ‘Marcia Angell’) Physicians also rely on treatment guidelines that are determined by folks who are on pharma payroll. But guess who is also on the payroll? The FDA which takes payment from the pharmaceutical industry to process approvals. (See ‘David Graham’ for more on this.)
And for the record, this is not a rant against doctors, but rather a system that is a mess. The solutions must come from savvy patients, change within the medical community, and a government/FDA that puts the public interest first.
and you have a good day.
On every other page of a women's magazine is an article about a dread disease you never knew about followed by a big, glossy ad for the drug to fix it. Of course, drugs usually don't fix anything. They treat symptoms. Everyone knows that just treating symptoms is poor medicine. A real healer will ferret out the cause and eradicate that.
producing truly superior cost effective drugs cost a tremendous amount of money. in fact producing drugs statistically superior to placebo is enormously expensive. drug companies need profit in order to function competitively and in the best interests of all of us. that's the way of it. and in my opinion, as someone who has worked in the pharma industry for 20 years (and in marketing and a chick to boot), the purpose of dtc is to inform and empower the patient and caregiver regarding available options. the only drugs that are marketed dtc are those with an roi that supports the initiative. by definition, those are the more costly drugs (biologics) or the more pervasive, less costly drugs (Pepcid, Tagamet, Prevacid, etc...the soda pops of the pharma industry). marketing is not by definition evil. and all the people in pharma marketing are not driven by some weird desire to snow the public to enrich themselves. most of them choose this industry because ultimately, they are working on products that positively impact patient lives and make a difference.
Yes, and the best way to insure profit is to have a country full of prescription addicts. Especially on the incredibly specious psychiatric end.
"producing truly superior cost effective drugs cost a tremendous amount of money."
Indeed, but the majority of those funds come from the taxpayers, and the research is performed primarily by the NIH, not the pharma companies. No, more of their money goes to the marketing budget than to R & D--but if you do/did work for a Pharma company, then you know this.
Jeez, you lobbyists are so lame with your passive lead-in and low-key apologist rhetoric.
Take a different tack if you want to be believeable.
I have made a correction to this fallacy below. Again, pharma companies cannot use the NIH funded research results for free. NIH funded research that is useful for the drug industry is patented by the universities / professors. Pharma companies that would like to use the result must pay licensing fees / royalties to the professors / university resulting in tremendous profits for the university / professor (and professor's biotech company). NIH funded research is no where near what industry drug discovery research is. It aims for more fundamental questions. Drug research is very focused on finding and optimizing particular compounds for a particular target that is implicated in disease. Academic researchers cannot afford to conduct the type of research that pharma companies do. It takes billions of dollars and 100s of researchers to find and optimize a single drug for a given target. I believe the government (tax payers) should retain partial ownership of the patents resulting from NIH funded research.
Pure unadulterated hogwash…..Cost effective by what means. The usual argument is that the medication saves money by allowing the patient to be treated as an outpatient versus inpatient and much more expensive care. In the 30 years I have been a pharmacist I have never heard of a patient being hospitalized because of restless leg syndrome, PMDD, fibromyalgia, or any of the other conditions which the DTC adds pimp very expensive medications for. The fact of the matter is that several independent retroactive studies have shown that the medications invented over the last 10 years offer little or no advantages over those that were already on the market, many of which are available as cost saving generics.
Big Pharma has absolutely no incentive to produce anything but an expensive medication. Currently, about 95% of the people in this country only pay a copay for their medication and have no idea how much that drug actually cost either their employer (self funded plans) or their insurance company. For example, fentanyl is not an expensive medication. It has been used in hospitals for years and is reasonably priced when bought in amps. Lollypops are dirt cheap. I can buy a 5 pound bag of them at Walmart for a couple of bucks. But put fentanyl in a lollypop and voila you know have a medication which even in generic form cost about $50 a dose. The average cost of a month’s supply is several thousand dollars. If the US still used a fee for service model prices would drop dramatically. Imagine what would happen if a patient went to their pharmacy and were told they would need to cough up $3000 for their rx. They would immediately call their md and demand a more cost effective medication and in most cases one or more are available. Unfortunately, the patient goes to the pharmacy and pays on average $20 for that outrageously priced medication and never sees what the actual cost of it was. Big Pharma exploits this pricing model to the fullest extent possible and it needs to stop…..
See Kathleen Slattery-Moschkau's Profile
Great point and in many ways this applies to all of healthcare and not just pills. For instance, if the pricing of procedures was more transparent (and if patients had to pay directly), my guess is we would all be asking much better questions before moving forward with costly operations that have big risks and questionable results. (‘Stents’ are just one example.) This lack of knowing and due diligence by the patient proves dangerous to us as individuals and has heathcare costs careening out of control. We cannot rely on industry to give us straight answers and even our doctors are facing marketing forces which can lead to recommendations that are not always in our best interest. That is why it is critical that we, the patients, don’t just plod along as a cog in this machine. We need to stay alert to conflict of interest, ask good questions, and when necessary…push back.
This goes hand in hand with the premise that Capitalism does NOT promote innovation. At this rate, we will never cure another disease again. You may live longer, but there is no incentive to cure anything if you can pop pills and continue the profit growth of a pharmaceutical company.
Insights like this are not rocket science, yet we still teach the opposite in schools everywhere in America. Capitalism supposedly spurs growth and innovation. So why don't we have cars that get 100 mpg all over the road? Or non-addictive sleep aids, ultra efficient lights, electric motors, or cheap, safe nuclear power?
We run in a system that innovates only when the maintenance of a product or service becomes more expensive than a replacement, and less profitable. Only when societal outrage, or lack of income sets in do we take charge and innovate our way out. Many times, it is far too late, and much more expensive in treasure and blood than it would have been had we left the profit margins out of the equation.
Not to say these companies should not make money, but measuring the return on pharmaceutical investment in the almighty dollar alone has proven to be not only inefficient, but deadly.
Women are the targets of the ads and women are big time in the sales of drugs. Whenever I'm in the doctor's office a cadre of sweet young things wait in the lobby to offer doctors insight into the new drugs and peeks at their cleavage, chased by a beaver-shot.
What many people don't realize is that much research is conducted at the National Institute of Health and was (or maybe still is) give to the pharmaceutical industry to puruse.
Senator Bernie Sanders tracked the history of drug funding in a senate speech a few years ago. Basically, he said taxpayers pay for govenment reserach, provide grants for pharma research AND pay at the pharmacy counter. In effect, we're all paying three times for each pill we swallow.
And YES the idea of consumer marketing of pharmaceuticals has backfired. It's intent was to give patients information to discuss options with doctors. Remember, it took state laws to required physicans to discuss lumpectomy as an option for a woman needing breast surgery. The medical industry has proven over and over again that it's only interest is in garnering profits and will steer patients to the most expensive, often unneeded, tests , treatments and medications available.
This is an important article and I hope you continue to let people know the facts behind the pharmaceutical industry's drug development and marketing policies.
I agree the mass marketing of big pharma can be excessive and certainly seems exploitive with certain female conditions, however, HPV leads to cervical cancer in women in their 50's, women can die. Taking a vaccine that can lead to erradicating the disease is not advertising, it is medical progress. Say what you want about RLS, HRT, and Vioxx, but HPV is a real medical problem for women.
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