Patient Care vs Profit
Pharmaceutical Industry: Patient Care vs Profit
Brief Industry History
The pharmaceutical industry has its early beginnings from the mid-1800s to the time of the 2nd World War. During those times, discovery of compounds that can be used for treatment was being widely explored even with only minimal research. The discovery of penicillin by Alexander Fleming in 1920s marked a milestone in the history and industry of drug discovery. Expansion of the pharmaceutical industry, however, did not come until after World War II, during mid-1900s. Around this time until 1990, the world saw the birth of major pharmaceutical companies, particularly that in the U.S, such as Merck, Eli-Lily, Bristol Myers, Pfizer. This period also marked a great change in the area of drug discovery where companies would explore a great number of new compounds for diseases that were previously without known cure. (Mowery & Nelson, 1999)
It was also during this period that drug research and development (R&D) became considered as a highly lucrative and engaging business mainly due to the activity’s many “unchartered fields”. At that time, there were still many drug compounds to discover, diseases to find cure to, and drug & body mechanisms to uncover. It was a win-win situation for both the pharmaceutical industry and the health care industry. While profits of drug companies grow at an annual rate of 18% during the 1980s, there is a steady line of new drug products that can be used for treatment of a greater range of diseases from common migraine to lifestyle cardiovascular disease. (Mowery & Nelson, 1999) With the addition of clinical trials and research, consumers and patients are further assured of drug safety and efficacy.
Through the decades, however, much has changed from the world of pharmaceutics, especially considering the business side of it. With the sudden influx of drug company discoveries, more and more, pharmaceutical companies are turning their resources from the costly research & development methods to the advertisements & marketing strategies that bring in additional profit (Applbaum, 2006). With this, two kind of marketing strategy has been developed and practiced by companies throughout the years. These are: (1) marketing to health care professionals, particularly physicians, and (2) marketing to consumers, or the creation of medical consumers.
Target Market to HCPs, to Consumers
Specifically with ethical drugs or those that require a prescription, drug companies promote and advertise drugs through medical journals and physician recommendation. The usual practice with most companies is that medical representatives would go to a doctor’s clinic or hospital to give free samples of their drugs while they try to list down the advantage of their product from others available in the market. Direct-to-physician advertisement may have the advantage of allowing physicians to know the different drugs available and assessing the pros and cons of each, thereby making a sound choice for prescription of medicines.
While this is generally acceptable and harmless, aggressive marketing has allowed abuse of this practice to extend to sponsorships and gift-giving, which are outside the company’s objectives. This practice becomes the source of bias in the industry making large companies benefit and gain more due to their high budget for promotion and marketing. Of the $11 billion spent annually for pharmaceutical promotion and marketing, sales representative uses roughly $5 billion for all their activities including that of physician activities. An estimated $8,000 - $13,000 budget is spent per year per physician (Wazana, 2000).
Another type of marketing strategy that is relatively modern and upcoming is the direct-to-consumer selling and promotion. These strategies paved the way for drug commercials, which can be seen on TV or heard over the radio. Though these infomercials are generally practiced for over-the-counter or a non-prescription medicine, Applbaum in his article has recognized the expanding influence of the pharmaceutical industry on the average consumer (Applbaum, 2006). Because of the nature of free choice, people have become more emboldened to make medical decisions on their own, even without the help of health care experts. Marketing advertisements not only include information about the drug but also “active proponents of exchange” such as actors, physicians, leaders, etc. all promoting a certain drug and claiming its efficacy and safety (Applbaum, 2006). All these have transformed patients from mere “recipients of medical care to active consumers of the latest pharmaceutical” (Applbaum, 2006).
Ethics of Pharmaceutical Business
As with any existing industry, the business of drugs is still governed by proper morals and conducts. For the pharmaceutical industry, however, the relation between these ethical principles and the marketing advertisements is still a bit vague and interspersed. Some pharmaceutical companies would generally think of their drug information dissemination and promotion activities as a service to the public, while being able to gain profit for the business they established. “Doing good while doing well”, Applbaum termed it. There is also the case of the informed or “medical consumers”, which is claimed to be ethical through autonomy or self-determination.
In all these, there is a need to know that the goals of business and the goals of health care will always come down to two separate entities, one entitled to fulfilling the self while the other entitled to fulfilling others’. Perhaps being knowledgeable of drugs may help in our being illiterate of the industry, but our knowledge can only take us so far. In this case, it will only take us to that which the pharmaceutical companies want us to know and learn.
References
Applbaum, K. (2006). Pharmaceutical Marketing and the Invention of the Medical Consumer. PLoS Medicine, 3(4): e189. doi:10.1371/journal.pmed.0030189
Mowery, D.C., & Nelson, R.R. (1999). Sources of Industrial Leadership: Studies of Seven Industries. UK: Cambridge University Press.
Wazana, A. (2000). Physicians and the Pharamceutical Industry: Is a Gift Ever Just a Gift?. Journal of the American Medical Association, 283 (3), 373-380. doi:10.1001/jama.283.3.373
