Big Pharma: Marketing Disease and Pushing Drugs
by Vin Miller
The truth about how the drug industry operates is not nearly as innocent and noble as it’s bright and cheery drug commercials might lead you to believe. The drug industry accounts for more than a half trillion dollars of revenue per year and has grown to be so powerful and influential that it might as well be a branch of government.
Because of this tremendous influence, millions of Americans are taking potentially dangerous medications that they don’t need. To avoid being one of them, it’s important that you understand how this powerful industry operates.
Buying the Partnership of Doctors and Politicians
Starting with the first day of medical school, doctors are treated like royalty by the big drug companies. They are given all kinds of free products, and in some cases, are even given bonuses, vacations, and a number of other incentives. Pfizer, the world’s largest drug manufacturer, was recently fined a record breaking $2.4 billion for this type of behavior.
Doctors and drug companies claim that these activities have no influence on prescriptions, but if this were the case, the drug industry wouldn’t be spending billions of dollars to promote their products to doctors. Furthermore, research has shown that doctors are indeed influenced by these marketing efforts and drug companies know this because they track prescription records. Drug companies put such an emphasis on this type of promotion that the ratio of drug representatives to doctors is nearly 1 to 4.
Medical professionals aren’t the only people that the drug industry is befriending. They have deep political connections as well and contribute more money to political campaigns than any other industry. Perhaps this is why the FDA’s regulation of the drug industry is so lax.
Research that’s Biased and Deceitful
As unbelievable as it sounds, the FDA actually expects drug companies to research the safety of their own drugs. The drug industry takes advantage of this by selectively publishing favorable research, discarding unfavorable research, and even manipulating results. Because the drug industry also has a significant influence on medical journals, research is typically published without the data which makes it difficult to verify the conclusions that were drawn. Some medical journal publications are even ghostwritten and published under another name.
One of the most unsettling examples of this type of biased research is with the drug Vioxx which is a nonsteroidal anti-inflammatory (NSAID) that was primarily intended to treat arthritis. Despite research indicating that Vioxx wasn’t any more effective than Aleve and had the added risk of cardiovascular side effects, Merck concealed this information and pushed the drug heavily. As a result, approximately 100,000 people suffered from heart attacks prior to the drug finally being pulled off the market.
Sneaky Marketing Tactics
The drug industry often claims that the high cost of their drugs is necessary to pay for the extensive amount of research that’s needed to create them, but this isn’t the truth. The drug industry actually spends twice as much on marketing as it does on research. During the year 2000, more money was spent on marketing Vioxx than Budweiser and Pepsi.
Drug companies are also clever about manipulating commercial rights. As long as they have a patent on a particular drug, they have exclusive rights to it and can charge a high price. Because the FDA only requires that new versions of an existing drug be tested against a placebo, there’s no need to prove that the new version provides any improvement, and as a result, it’s easy to obtain a new patent for an existing drug by changing it ever so slightly. More than three quarters of new drugs are a byproduct of this type of strategy and aren’t any different than what’s already on the market. To make matters worse, the limited amount of money that drug companies dedicate to research is often used to support this type of trickery.
AstraZeneca’s Nexium, a popular medication for acid reflux, is an excellent example of this. By the time that AstraZeneca’s patent on Prilosec was about to run out and they were at risk of losing $6 billion in revenue per year, they created and patented Nexium which is almost identical to Prilosec and isn’t any more effective. During this process, doctors were encouraged to prescribe Nexium instead of Prilosec even though Nexium is up to 7 times as expensive as Prilosec and no more effective.
Targeting Patients Directly
A relatively new marketing tactic for the drug industry, which has been quite effective, is to advertise directly to the general public through the influence of television. You’ve probably seen countless drug commercials that associate a wonderful scenario of happiness and health with a particular drug. They conclude by telling you to ask your doctor about the drug, and according to a number of doctors, many people are following orders. In fact, some people are belligerently demanding prescriptions for drugs that they saw on television without even knowing their purpose or risk. There have even been cases of women requesting Viagra and Cialis.
Unfortunately, the FDA doesn’t require drug commercials to be approved before they air, and when an issue arises regarding deceptive advertising, it takes an average of 4 to 6 months for them to respond which is much too late. Sadly, the FDA even defends drug commercials claiming that they educate the public and get people to their doctors. How’s that for influence?
Inventing and Selling Illness
The drug industry has a significant influence on research, medical journals, physicians, patients, and even our government. Drug representatives have physicians wanting to prescribe the latest medications, and television commercials have patients requesting them. It’s a very successful and profitable business model.
As if the existing amount of influence weren’t enough, drug companies create even more by making the common challenges of every day life seem like a disorder that requires medication. When a drug company receives approval to promote an existing drug for the treatment of a new condition, it makes the drug eligible for a patent extension. As such, drug companies have a tremendous incentive to find new conditions to treat with existing drugs, and when they can’t, they invent them.
For example, the drug Sarafem is really Prozac with a different name and a different color capsule. It’s patented, approved, and promoted for the treatment of “Premenstrual Dysphoric Disorder” which is defined as the sadness, irritability, tension, and moodiness that might occur prior to menstruation. Even though this drug isn’t any more effective at treating these symptoms than generic Prozac, it’s up to three times as expensive.
Another common tactic is to change the definition of existing diseases. For example, changes to blood pressure and cholesterol level guidelines could qualify millions of new people for prescription medication literally overnight. When this happens, it’s not uncommon for the supporters of such changes to have financial ties to the drug companies that would benefit most.
It’s About Much More than Drug Costs
The fact that drug companies are charging high prices for drugs that aren’t any more effective than generics serves as a revealing example of what the drug industry cares about most, but cheaper generic drugs aren’t necessarily the answer to the many health care issues that we face today.
One of the major problems with modern medicine is the symptom chasing mentality that neglects to address the root cause of most health problems. Unfortunately, the significant influence of the drug industry has encouraged the majority of medical professionals to embrace this philosophy, and as a result, they’re only relieving their patient’s symptoms without actually resolving their problems. In many cases, the problems become worse despite the patient being relieved of discomfort.
Prescription medications are a tremendous help for many people who suffer from horrible conditions that are completely out of their control. However, the majority of people who take prescription medications don’t fall into this category. What more people need to realize is that optimal health is the true foundation of the happy and healthy scenarios that are portrayed by drug commercials and that following the basic principles of a healthy lifestyle is often much more effective than taking a pill. Furthermore, these commercials never tell you that adverse reactions to properly prescribed drugs are the 5th leading cause of death in the United States. They cause 100,000 deaths and 1.5 million hospitalizations each year.
As easy as it may seem to blame the drug industry for all this, it’s really not their responsibility to look after anyone’s wellbeing. Although their behavior is despicable in my opinion, it’s the responsibility of the government to not allow corporate interests to develop such a strong influence, and it’s the responsibility of the general public to seek knowledge and make informed decisions.
What You Can Do
A nonprofit organization called No Free Lunch has been established to encourage medical professionals to practice based on unbiased scientific information and to not accept money, gifts, or any form of hospitality from drug companies. To find a medical professional who has made this pledge, visit NoFreeLunch.org. Depending on what kind of assistance you need, it might be even better to seek the assistance of a naturopath. You can do so by visiting The American Association of Naturopathic Physicians.
In most cases, I believe that prescription medications should be a last resort. However, if you do decide that a prescription medication is the best choice for you, consider subscribing to Consumer Reports Best Buy Drugs or visit Worst Pills, Best Pills to assess the safety of the drugs that you’re considering.
An Excellent and Free Documentary
Most of the information in this article is based on a documentary called Big Bucks, Big Pharma – Marketing Disease and Pushing Drugs. If you’re not fully convinced of the drug industry’s deceptive ways and the fact that your health is not their top priority, then I highly recommend that you take the time to watch this video in it’s entirety.
Post this on Twitter
Post this on Facebook
Support this on StumbleUpon
Email this to friends
Leave a comment
Spot on once again Vin! Have you read “Selling Sickness? ” One CEO’s goal was to sell drugs to EVERYONE, even HEALTHY PEOPLE… Every year the drug companies get together and collaborate on how to expand a certain “disorder” so they can bank in some more cash.
Pretty soon a commercial will run like this:
” Have you ever cried?”
YOU NEED (Insert crazy name of drug here.)
P.S (small typo: you typed not profit organization when I think you mean non-profit.)
-Bud
Hey Bud,
Selling Sickness is sitting on my bookshelf waiting to be read along with many other great books.
Thanks for pointing out the typo!
One of your best articles to date… I’m going to send a link to my representative in Washington… they obviously don’t have time to read stuff like this, they are too busy researching how to exactly model the existing health insurance system, but hey, they need to know we are discussing things like this in the private sector.
If you watch this documentary, you will see that it does no good to write to any government rep as they seem to be involved in this too. Listen to the part where it says the drug companis have a huge stranglehold on Congress. Big Pharma is the a significant cartel in America and don’t think for a minute that it doesn’t go all the way up to the top as far as corruption.
Just sayin..sad ..but true!
Hi Jon, thanks for your comment and your effort to help make a difference! In regard to what Sharona said, I certainly don’t think it hurts to express your concerns to local politicians, but it might be more effective to share issues like this with friends and family. If you have the time and motivation, you can do both.
Sadly, we are a nation full of drug addicts. Other than myself, I know no one who is not taking at least one prescription drug, and most of the people I know take numerous prescriptions.
Hi meatlessmama, thank you for your comment!
I’ve been surprised many times by people who look fairly healthy but are on one or more medications. It makes me sad every time.
Great article Vin.
Somewhat related, I recently read this in Wired which I thought you might enjoy. The power of your mind is in many cases more powerful then pharmaceuticals.
Thanks, Bruce! That’s a great article from Wired. It’s a shame that the medical community regards the placebo as just a benchmark and sometimes even a nuisance rather than seeing it’s potential to be an effective therapy in it’s own right. The following paragraph sums this up perfectly.
“Beecher’s prescription helped cure the medical establishment of outright quackery, but it had an insidious side effect. By casting placebo as the villain in RCTs, he ended up stigmatizing one of his most important discoveries. The fact that even dummy capsules can kick-start the body’s recovery engine became a problem for drug developers to overcome, rather than a phenomenon that could guide doctors toward a better understanding of the healing process and how to drive it most effectively.”
I disagree with the statement that placebo can’t eliminate a tumor, and it’s really unfortunate that the drug industry is exploiting the eagerness of other cultures to embrace the use of pharmaceuticals.
Hi Vin. It’s such a twisted up mess because of past policies of the FDA it is so expensive to bring a new drug to market, that it is impossible for any smaller and responsible company to compete with big pharma. The partnership of big money interests with doctors and the government makes this an almost unresolvable problem.
In my opinion it is the new connected universe we live in now that allows us to find out valuable and true information outside of the credentialed experts (i.e. doctors and government bureaucrats) that is the only solution. That means each person has to take responsibility for themselves. There are organizations committed to integrated health care and prevention that are growing and I think will eventually win.
The main threat to that is if they are eventually outlawed as part of a massive government controlled program that eliminates the alternatives. I’m more scared of big government than I am of big corporations. At least with the latter I can choose to ignore them. The internet is going to eventually kill them anyway. My hope is it does the same to big government.
Slowly but surely they’ll fall under their own weight… only once we learn!
Hi Stephen, thanks for sharing your thoughts! I agree that big government is more scary than big corporations. However, the distinction between the two is becoming less clear. I also agree that the internet is a major asset in being able to overcome this problem and I think that we all need to take responsibility for ourselves no matter what.
I am not surprised that Doctors are given incentives to push expensive prescriptions on their patients. Over half of the American population currently taking daily prescription medication, some having to decide between their drugs and their next meal! I agree with Stephen that the internet is going to (hopefully) run big business pharmaceutical companies underground. Medtipster is a search engine online that helps you find discount generic drugs instead of super expensive name brands!
Hi Nadia, thank you for your comment!
This is a sad scenario. Fresh the movie or Food, Inc., I can’t remember which, showed a family who couldn’t afford much other than fast food partially because of the expense of the father’s diabetes medication. The food choices that they were making were creating the need for the medication which was in turn inspiring even worse food choices. It’s a vicious cycle and getting out of it usually requires more awareness than simply knowing what the cheapest generic drug is.
Thanks for pointing out Medtipster.
” The food choices that they were making were creating the need for the medication which was in turn inspiring even worse food choices. It’s a vicious cycle and getting out of it usually requires more awareness than simply knowing what the cheapest generic drug is.”
Exactly! I wish everyone could get this. More and cheaper drugs are not the answer. In most cases healthier food and lifestyle would eliminate the need for drugs.
thanks for the great article.
I used to, many years ago, work in the health insurance industry. A lot of what you wrote about are the same gimmicks insurance (HMO in particular) use(d) to get doctors to keep costs down, ie: adding a year end bonus if the doctor’s overall ‘expenses’ were less than a particular amount.
Having been stuck in an HMO at one point and knowing the system I actually put off a surgery until January, where the doctors had a fresh budget work with.
Hi Mike, thanks for sharing your experience! Yes, the health insurance industry is very powerful as well. It’s unfortunate that there is so much influence, even outside of the issues with prescription medication, distracting many medical professionals from what matters most.