Truth in advertising is an oxymoron.

                                                                    Donna M. Midkiff

Donna M. Midkiff, PsyD

Stopping smoking today will result in immediate mental and physical health improvement.  See what Philip Morris says today about tobacco use.

Pharmaceutical Industry Influence

             Is academic medicine for sale?  Marcia Angell, Editor in Chief of The New England Journal of Medicine (2000), asked that question in an editorial prompted by a study on antidepressants. She reports that many authors have financial links to drug companies, links so numerous that there is not enough space to list them all in the journal.  Angell acknowledged violations of journal policy which prohibits review articles and editorials written by an author with a financial interest in his or her topic. Moreover, Angell (2000) postulates that drug companies are increasingly promoting diseases to fit drugs and that common people are coming to believe they suffer from serious ailments.

The pharmaceutical industry has gained much by its efforts at convincing professionals and laypersons that biology is the cause of abnormal behaviors.  According to the April 2003 issue of Pharmacy Times, the anti-psychotic, Zyprexa and the anti-depressants Zoloft and Paxil were sixth, ninth and tenth respectively, among all drugs, in 2002 overall sales, generating almost $8 billion dollars in revenue for the pharmaceutical industry that year.  Although Neurontin is a medication that is FDA approved only for the treatment of seizures and pain, its common use for mania made it number twelve in overall sales, with over $2 billion in sales. The anti-psychotic, Risperdal, followed at number 15 with $1.8 billion in sales, and the anti-depressant Celexa ranked twentieth with $1.5 billion in sales.  Sales growth in 2002 ranged from 10.7% (Paxil) to 39.9% (Celexa). According to Pharmacy Times, advertising to consumers and physicians was a driving influence in raising awareness about anxiety and depressive disorders (Vaczek, 2003).  This particular success in advertising has significant implications.  Research demonstrates that when a consumer responds to an “ask your doctor” campaign, over-prescribing of medication occurs even when the patient presents with minor symptoms (Kravitz, Epstein, Feldman, Franz, Azari, Wilkes, Hinton, & Franks, 2005).

Pincus (1998) reported that psychotropic prescriptions increased 20% from 1985 – 1994 in the United States.   During this same time period prescriptions for stimulants tripled and those for mood elevators doubled to 20 million.  In the span of one decade (1990 – 2001) production of Ritalin increased 700%, which was also consistent with increased advertising.  In Pediatrics the number of full-page advertisements for stimulants doubled from 1990 – 2000 (Wyatt, 2003).  In 1996 USA consumers were spending $3.8 billion a year on anti-depressants.   That had nearly tripled to $9.9 billion by 2001 (Millenson & Shalowitz, 2005).

Pfizer, a well-known pharmaceutical company, includes in its mission statement, “We dedicate ourselves to humanity's quest for longer, healthier, happier lives through innovation in pharmaceutical, consumer, and animal health products” (Pfizer, 2003).  Pfizer describes a budget of $5.3 billion for research and development (R&D) as a path to its mission (Pfizer, 2003).   However, United States R&D discovery of new molecular entities (medicines) is significantly below global standards and generated revenue remains sizeable relative to profit versus R&D budget (Light & Lexchin, 2005).

Funding resources are often channeled to the development and marketing of what industry critics term “me-too” drugs and the practice of “evergreening” (Bloice, 2005).  Me-too drugs refer to medications that come on the market to compete with a new drug that has taken market prominence – and profits.  Rather than develop a new drug to tackle a troubling medical condition, corporations develop drugs to compete with market leaders.  “Evergreening” involves employing the same basic research used to manufacture one drug in order to make available a new, slightly different one.  When the patent on the original drug is about to run out and other companies are preparing to launch generic, cheaper versions, the new version is promoted through direct advertising to physicians and consumers.

In a submission for public hearing in 2005, Donald W. Light, PhD, University of Medicine and Dentistry of New Jersey, and Joel Lexchin, MD with the School of Health Policy and Management of York University wrote, “The most objective research on corporate R&D in the United States reports that just under 12 percent of domestic sales is devoted to R&D, not the much higher figures cited by industry leaders.  Thus, contrary to what the pharmaceutical industry claims, in relative terms, R&D spending outside the U.S. is more intense and more productive than in the U.S.”  (Pharmacy Times, 2003; Light & Lexchin, 2005). Typically a new drug’s sales increase by no more than 14 percent per year, however sales of drugs heavily advertised to consumers surge by more than twice that amount, on average 32 percent a year (Good, 2003; Pincas, Chang, Tol, & Hubert, 1993).  Read more commentary on the role mass media plays on our belief systems.

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Truth In Advertising