Anne Dunev at The Huffington Post recently called attention to a thought-provoking article published at the peer-reviewed journal of the Public Library of Science. Titled “The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States,” the 2008 article by Canadian academics Marc-André Gagnon and Joel Lexchin concludes:
From this new estimate, it appears that pharmaceutical companies spend almost twice as much on promotion as they do on R&D. These numbers clearly show how promotion predominates over R&D in the pharmaceutical industry, contrary to the industry’s claim … (I)t confirms the public image of a marketing-driven industry and provides an important argument to petition in favor of transforming the workings of the industry in the direction of more research and less promotion.
Dunev elaborates on the way the pharmaceutical industry’s drive for growth has distorted public perceptions of diseases and how to treat them. She writes:
You don’t have to be a financial pundit to know that any public company is responsible first and foremost to their stockholders. As a public company how do you meet your fiduciary responsibility? You ensure the price of your stock by increasing your bottom-line.
Does that require that you make up new “diseases” as you go? (Restless Leg Syndrome, for example.) Do you bend the rules of science in how you determine what constitutes disease so you can repackage old drugs that have lost their patent? Do you push dangerous new drugs on the market knowing that a little collateral damage is the price of making money, just as it is the price of making war?
According to USA Today in 2005, there were 1,274 registered pharmaceutical lobbyists in Washington, D.C. — more than two for every member of Congress. In 2003, $143 million was spent on lobbying activities by the Pharmaceutical industry. There are more lobbyists from pharmaceutical than any other industry trying to bend legislators’ ears.
This is big business, and that means that your health care is not in the hands of people who really want to help you, but in the hands of people who view you as a market. Caveat emptor.
Clearly, whatever healthcare reform the government enacts must include some control over pharmaceutical marketing. Remember, less than 20 years ago, direct-to-consumer advertising by pharmaceutical companies was not permitted by the FDA. That would seem to be a good start as we try to get drug costs back under control.147