Critics of the pharmaceutical industry have long contended that it engages in “disease mongering,” or using marketing techniques to expand the definition of disease and accelerate drug prescribing. Direct to consumer (DTC) advertising has been a key focus of their ire. They suggest that drug commercials increase patient requests for advertised drugs unnecessarily.
In recent years, drug firms have come under increased pressure to limit DTC advertising. In 2005, the Pharmaceutical Research and Manufacturers of America (PhRMA) responded by producing voluntary guidelines restricting (among other things) the content and number of commercials member companies are permitted to develop. PhRMA also established an Office of Accountability to help monitor compliance with its new recommendations.
Surprisingly, the new PhRMA guidelines resulted in more DTC commercials. According to ePharmacy Times, spending on drug advertising increased by 11 percent between January and February 2006 compared to the same period in 2005.
Although drug firms have increased advertising spending, they are producing more “non-branded” commercials. These types of advertisements educate on a specific condition like heart disease or erectile dysfunction rather than touting a product.
Drug firms are also engaging in other activities to educate consumers about conditions their products treat, including:
-“cDetailing”: This involves developing content heavy Web sites, brochures and other materials that provide consumers with high quality medical information. One prominent example of a drug firm that is engaging in cDetailing is Sanofi-Aventis. The company is using a combination of DTC print advertising (branded and non-branded), direct mail, online marketing and other tactics to promote its sleep aid Ambien.
-Public Relations: PhRMA’s guidelines also ask pharmaceutical companies to observe a voluntary moratorium on DTC advertising when a drug is first approved by the Food and Drug Administration (FDA). However, this has not stopped them from promoting their products at launch. In 2005 Advertising Age reported that some public relations firms were being asked to “ramp up” their efforts to secure media coverage when a medication is cleared by the FDA.
For Industry Critics Educational Campaigns = Disease Mongering
Despite PhRMA’s guidelines, industry opponents continue to advocate for a ban on DTC advertising. For example, in September 2006, the Institute of Medicine issued a report calling for a two-year restriction on DTC commercials after FDA approval. Given this, it is likely that pharmaceutical companies may produce more non-branded promotional initiatives to stave off regulation and criticism. However, these efforts may have a limited
positive impact because some view educational campaigns as another form of disease mongering.
For example, in 2005 the Seattle Times published an extensive series, “Suddenly Sick,” that focused on a range of educational activities, including pharmaceutical company support of guidelines developed by medical societies. One article outlined how physicians with ties to industry helped to develop recommendations calling for the use of medications in obese people. It implied that drug companies exercised undue influence on the development and interpretation of the guidelines.
In February 2006, an article in the Washington Post suggested that the American Diabetes Association (ADA) and the National Osteoporosis Foundation (NOF) rarely raise warnings about drug safety because they do not want to offend the drug companies that fund their activities. According to patient diabetes expert and blogger Amy Tenderich: “Those of us in the diabetes community also disseminating information take everything the ADA says with a grain of salt. It is clear that the organization . . . is very careful not to step on the toes of its supporters and the advertisers in its magazines.”
Greater Transparency & Proactive Communications May Help Combat Skepticism
Clearly, the public is suspicious of pharmaceutical industry produced and sponsored educational campaigns. Given this, proactive communications and greater transparency will be required to bolster the credibility of these initiatives. This could include:
-Explaining why the educational campaign is taking place: A pharmaceutical company could acknowledge that they are interested in educating on a disease partly because they produce a product that treats it. However, the firm could also highlight its commitment to improving treatment of the illness, their efforts to ensure access to their medications and research in this area.
-Talking about who is sponsoring an activity or organization: For a medical society this might involve revealing who is funding an activity and how it is ensuring that it remains independent.
Traditionally, physicians, medical societies and drug firms have been hesitant to reveal information about sponsorship and their motivations. However, as the pharmaceutical industry engages in more educational campaigns, from unbranded commercials to partnering with third party organizations, proactive communications will become increasingly important. Greater transparency will help build trust and, over the long term, improve health.
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