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The pharmaceutical industry has undermined the integrity of medicine by rendering healthcare providers, academic institutions, journals, government healthcare agencies, patient advocacy groups, and the media financially dependent on its largesse. This industry has bypassed the inconvenient scientific evidence of its products’ failure to show a positive benefit/risk ratio by use of fictitious “evidence” fashioned by sophisticated public relations firms. PR firms have also manufactured buzz about the latest “under diagnosed condition” (e.g. “female sexual dysfunction” “juvenile bipolar disorder” “restless leg syndrome”) for which there just happens to be a newly marketed drug available.

To create demand, industry has recruited influential professionals and professional associations and it has sent an army of attractive sales reps “sex icons” to woo doctors into prescribing. Industry has also recruited patient advocacy groups who can be relied on to bully third party payers to pay for the latest, most expensive drugs which are promoted as “breakthrough” therapies despite the lack of scientific evidence to back up such claims. Drug makers are driving sales from both ends: since consumers cannot purchase drugs without a physician’s prescription, advertisements directed at consumers prod consumers to prod their doctor ( “ask your doctor”) for a specific brand of prescription drug. Companies simultaneously pitch the drug to doctors personally through an army of company detailers (sales reps), in separate ads, in ghostwritten journal articles, and by controlling the content of continuing medical education courses. To ensure that physicians write brand name prescription drugs manufacturers offer prescribing physicians gifts and financial enticements (bribes). The medical profession has accepted industry’s ‘free handouts’ and ‘fee for service’ arrangement by offering the untenable argument that physicians are incorruptible. On the contrary, several studies have found that physicians who accept and dispense free samples to their patients are far more likely to prescribe those drugs than those who don’t take or have no access to samples.

 

Industry’s successful marketing strategy is measureable in increased number of prescriptions, increased sales, and in a nation that consumed $279-billion worth of prescription medications in 2006 — spending 80% of that on brand-name products that are advertised–their efforts appear to be paying off. The number of individual prescriptions filled in the US rose from 2.9 billion in 1999 to 3.7 billion in 2006.

 

 

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