As always, comments are encouraged and welcome!
Guest Blogger Sarah Fudin’s current title is Director of Inbound Marketing at 2U, Inc. She is just weeks away from a Masters Degree in “Branding” from the School of Visual Arts (New York, NY). This timeless “re-post” on April 30, 2014 is by request…
As originally posted March 12, 2013
Sarah Fudin is the community manager for the George Washington University’s innovative online Masters in Public Health program. Sarah enjoys working with GW as a way to positively effect change and become a life long learner. Follow her on twitter at @sarahfudin and @GWonlineMPH. After reading some recent articles about pharmaceutical spending on marketing, it sparked an interest because of the connection to public health. Most of us have seen those annoying advertisements on television that are followed by a litany of drug side effects. And many of us are affected by the high cost of pharmaceuticals which sometimes is the reason that patients in need of them are noncompliant. According to a recent report, “Drug companies spent nearly $84 million marketing pharmaceuticals in the District of Columbia in 2011, including an outlay of nearly $19 million for gifts given to physicians, hospitals and other health care providers, according to a report by researchers at the George Washington University School of Public Health and Health Services (SPHHS).” Looking at this more globally, there are many advertising expenditures common to the pharmaceutical industry, who for purposes here we’ll call “Big Pharma”. These include direct-to-consumer marketing, payment to healthcare professionals, and payment to competitors to keep its product off the market. Perhaps the latter is most bothersome, but all of these costs may have legitimacy if it is critiqued purely from a business perspective. I personally have very mixed feelings because my education background is in business (and competitive sports), I come from a family of healthcare professionals, and now I’m looking at things from a public health perspective. The fact is, that depending on goals, assertions can and have been made for or against any of these three marketing domains. Before we criticize all that Big Pharma does, perhaps we need to put things in perspective.
- In 2011, Big Pharma spent $2.4 billion direct-to-consumer (DTC) television ads, a 23% drop from the $3.1 billion spent in 2007.
- In 2006, the most recent available data indicates that five of largest cigarette manufacturers spent a total of $12.49 billion – or over $34 million dollars a day for DTC advertising.
- As of 2012, “the NBA, NHL, MLB, and NFL are worth, combined, more than $12 billion. Furthermore, over the next decade, the value of professional sport teams is going to rise to unpredictable levels.”
All of these statistics are important. Obviously, there is greater than 5 times as much spent in direct-to-consumer advertising to encourage people to smoke –public health risk for sure. Big Pharma does spend a lot of money in DTC advertising, but those ads are highly regulated by the FDA. And one can argue that with the current obesity academic within the U.S. (a significant public health risk), perhaps the professional sports industry should pay money towards encouraging healthy lifestyles and exercise instead of sitting on a couch hours on end watching these highly paid athletes. What’s the connection between paindr.com and this post? During the recent FDA Hearings to change the indication for opioids, it was quite obvious that many advocates believe that deaths associated with prescription opioids are somehow a result of Big Pharma marketing. In fact, such stories implicating pain specialists as receiving “gifts” are ubiquitously spread throughout the Internet and in professional journals. So, I decided to research this and find out just what constitutes such “gifts”. Here’s what I found out… Gifts to doctors include “fee for service”, “continuing education”, and “grants for research”. Fee for service usually involves a “marketing program” in which Big Pharma arranges a dinner meeting or other gathering where their product is discussed in relation to its FDA approved indication. In this case, physicians are often paid $1,000-$2,000 to give a one hour lecture excluding time to prepare and travel to the venue. Considering that a single (less than one hour) spinal injection easily brings a fee of around $1000, this may not be so unreasonable. According to my sources, these speakers must go through an extensive training process and must sign documents acknowledging that they have no conflict of interest, that they will not base any patients medication selections on their speaking affiliation, and that they will adhere to all FDA guidelines-failure to adhere may result in removal from the speakers bureau or a law suit. All of these presentations are highly regulated by each company’s legal department and approved in advance by the FDA. Continuing education comes in many forms. A physician or other healthcare provider may be paid a fee to write a monograph that generally involves collaboration with an accredited college. This is a long peer-reviewed process that requires writing time, meetings, and collaboration among many healthcare providers and writing experts. Physicians are paid for their time spent to develop such monographs, but the money is paid first to a third party that monitors all of the content to ensure that all aspects of the subject matter are fairly covered and that no bias is giving to the supporting company or companies. Similar activities may occur with professional organizations, colleges, or hospitals, where a live lecture or lecture series is offered. In these cases, more than one Big Pharma company may add to the money pot, but they are all “hands off” in terms of the content. Their money is solely for the purpose of education and to acknowledge their interest to educate healthcare professionals – they are not allowed to market their product within the presentation venue. Paranoia among Big Pharma has become so prevalent that now they are precluded from providing pens or note pads containing the company logo at any of these events or to physicians upon a marketing call. Grants for research are variable. It may include a clinical research project that specifically studies a Big Pharma drug already on the market, one that has not yet come to market, or an available drug being studied for a new indication. Any of these are highly scrutinized and must gain approval from the investigative body within an institution, among other approvals. Often times Big Pharma will fund laboratory research in a disease state that interests them with regard to drug development. Before bashing Big Pharma, perhaps it is worth looking at the bigger picture.
- They are a business for sure, and as such will advertise to make money.
- Big Pharma is highly regulated and like any other large companies, spend a significant amount of revenue on advertising and lobbying efforts.
Considering that Big Pharma must adhere to strict internal and external regulation, be mindful of these decisions politically and from a public health perspective, perhaps they are not the untamed animal some would have us believe.