Physicians must reclaim their profession to ward off marketing predators

MADISON AVENUE ADVERTISING COMPANIES ARE ASSUMING CONTROL OF MEDICAL RESEARCH AND EDUCATION

FOR decades, physicians, scientists and pharmaceutical and medical device companies have collaborated very successfully to the benefit of our patients.
Unfortunately, advertising companies are now becoming major players in those collaborative efforts. This alarming trend is being exposed and condemned increasingly not only by the medical profession but also by patients and the press.

In her front page article in the New York Times on November 22, 2002, Melody Petersen wrote: "Madison Avenue – whose television ads have helped turn prescription medicines like Viagra, Allegra and Vioxx into billion dollar products – is expanding its role in the drug business, wading into the science of drug development".
The article cited examples of FDA clinical trials designed and conducted by some of the world’s biggest advertising companies and described how "critics worry that science is being sacrificed for the sake of promotion".

Quoted in the article was Arnold S. Relman MD, Professor Emeritus at Harvard Medical School, Boston, US and a former editor of the New England Journal of Medicine. He criticised this trend in medical research: "You cannot separate their advertising and marketing from the science anymore."

Advertising executives, according to the article, say they are "directing research towards drugs the marketers think could be big sellers" and designing and conducting "studies aimed at showing that the drugs have the qualities patients most desire".
According to these billion dollar advertising companies, it appears that we physicians and scientists must follow their direction for "desirable" medical development to occur.
Thomas Bodenheimer MD, University of California at San Francisco, described in the article the manipulation of "results of clinical trials by controlling a study’s design or choosing to make public only positive data".

He added: "The problems can only grow worse … with ad agencies involved … It introduces another bias into the whole clinical drug trial picture so that the American public and the physicians in the United States are not going to know, really, the true facts about the drugs."

Ms Petersen described in the article the current roles of advertising agencies not only in medical research but also in medical education.
She documented how, "armed with the results, ad agencies try to sway doctors’ prescribing habits."

"Some agencies own companies that ghost-write articles for medical journals. They also create continuing-education courses…," she added.
Linda Logdberg, a medical writer with a doctorate in anatomy, described in the article her work as a ghost-writer for one of the global ad giants and how "she had become increasingly disenchanted with the process".

Dr Lodberg gave an example of how, starting with an outline approved by the ad agency, she would write a manuscript.
"Typically," she said, "her manuscript would be sent to the drug company for approval before it was given to the doctors who were paid to be listed as authors … The marketing companies … will drop a doctor if they don’t think he will be particularly malleable … the result is marketing masquerading as science."

The practice of medical articles – even in peer reviewed journals – being written by ghost-writers continues to grow.
Federal and state investigations of marketing practices in the US are uncovering increasing numbers of scientific articles written by ad agencies and not by the listed doctors.

According to Dr Relman, "there was no place in medical education for ad agencies". He was also quoted in the articles saying, "we don’t get anywhere in medicine without objective data … That’s the coin of the realm. The whole purpose of medical research is lost of you do not tell the truth."

Just as managed care executives with little or no knowledge of medicine wrought havoc in patient care in the 1990s, ad agency executives similarly could destroy medical research and education in this decade.

When introduced in the early 90s, managed care companies were interested in gaining market share at any cost and at the expense of patients and physicians.
Patients, physicians, scientists, medical industry executives and medical writers are now becoming pawns of advertising companies eager to make profits at the expense of everyone in our industry.

If this dangerous trend is allowed to continue, we will see worse quality, higher costs and increased governmental regulation of our research, education and clinical practice.

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