Pushing drugs: how medical marketing influences doctors and patients

Science News, July 30, 2005 by Ben Harder

Citing cost-control measures, Donohue says, hospitals have increasingly restricted detailing. Some have also imposed limits on free samples and other items. Last year, for example, Affinity Health System of Wisconsin barred pharmaceutical companies from distributing to its employees free meals, clocks, calendars, and other handouts, and it restricted the distribution of free samples.

The notion is that physicians will feel more comfortable prescribing cheaper alternatives to brand-name medicines when they feel they don't owe a return favor to a drug company. "It's a wonderful idea" says Abramson.

However, he also notes, good treatment will always depend on a patient-doctor agreement. Abramson recalls one patient in his own practice who told him that she had seen an ad for Paxil and thought that she had a chemical imbalance that the drug could correct. Abramson, recognized that she had adjustment disorder and recommended counseling instead. His patient resisted the idea.

"Because she believed Paxil was what was necessary, I did prescribe Paxil--and counseling," he says. "It was the Paxil prescription that allowed her to buy into the process of counseling. That was necessary for moving toward a real solution."

Pharmaceutical industry spending * (BILLIONS)

                                 1997   2000    2003

Direct-to-consumer advertising   $1.1   $2.5    $3.2
Detailing aimed at physicians    $3.4   $4.8    $5.3
Drug samples (market value)      $6.0   $8.0   $16.4

* Source: IMS Health