Marketing

The pharmaceutical industry spends between $30 and $57 billion annually on marketing its drugs (including samples), the majority spent on marketing to physicians and other prescribers. Studies show that the industry influences prescribing through its use of gifts and payments to prescribers and through its role in financing continuing education for doctors and nurses. The industry also purchases prescription records and physician profiles that allow sales representatives to track individual doctors’ prescribing history in order to tailor sales strategies. Such marketing can increase costs by swinging prescribing toward newer, more expensive and less-tested drugs. It also provides doctors and patients with inaccurate or incomplete information about a drug’s risks, side effects and efficacy, and undermines medical professionalism with perceived and actual conflicts of interest.

Marketing can also harm patients by encouraging doctors to prescribe the newest, least-tested drugs before sometimes lethal side-effects are known. For instance, Vioxx, which worked no better ibuprofen for 95 percent of all patients, became a highly profitable drug because of Merck’s aggressive marketing. To increase its sales, Merck launched a massive advertising campaign that targeted doctors and patients. In 2003 alone, Merck spent nearly $500 million in promotions to doctors and $78 million in direct-to-consumer advertising, and pulled in 3 times that in sales.  By 2000, clinical trial data showed that Vioxx caused a five-fold increase in the risk of heart attack or stroke.  But Merck continued to use sophisticated techniques to influence physicians, such as company- (“ghost”) written journal articles and seeding trials - unnecessary studies to accustom physicians and patients to using the drug.  As a result, more than 20 million people took Vioxx before it was withdrawn from the market in 2004.

Community Catalyst works with state and federal policymakers, regulators, and academic medical centers to curb the inappropriate influence of pharmaceutical marketing on prescribing. In collaboration with the Pew Prescription Project, Community Catalyst supported the federal campaign to pass the Physician Payments Sunshine Act, which requires prescription drug and medical device companies to report payments to physicians into a publicly searchable online database.  We also collaborated with the Project and the American Medical Student Association on its PharmFree Scorecard, which assesses conflict-of-interest policies at all U.S. medical schools.

In addition, our Prescription Access Litigation project has brought several class action lawsuits to challenge deceptive practices by the pharmaceutical industry. These include withholding known risks from advertising materials targeting consumers and physicians, overstating the benefits of a prescription drug, and promoting the drugs for unapproved uses in violation of federal law.