Two York University researchers have published a study in the January 3rd issue of PLoS Medicine [Public Library of Science] demonstrating that U.S. pharmaceutical companies spend nearly twice as much money promoting their drugs to doctors and the public than on research and development of new drugs.

Big Pharma Spends More on Advertising than Research and Development puts the lie to the pharmaceutical industry’s self-serving mantra that the cost of drugs in the U.S. has to be higher than anywhere else in the world so that newer, better drugs – and drugs designed to treat relatively rare but deadly diseases – can be developed. High prices for prescription drugs offset this massive expenditure, they tell us, and the U.S. government has tended to accept the lie without challenge.

The study by Marc-André Gagnon and Joel Lexchin used data from 2004 (the latest available to them) from doctors and the pharmaceutical industry itself. Their analysis showed that drug companies spend nearly 25% of every sales dollar on promotion, but less than 13.5% on research and development. Out of domestic expenditures in 2004 on drugs of $235.4 billion.

Back in 2006 the New York Times published an article about another aspect of drug marketing, entitled Doctors Object to Gathering of Drug Data. This article describes the practice of pharmaceutical companies keeping computerized dossiers showing which physicians are prescribing what drugs. This lets drug sales representatives pressure a doctor to write more prescriptions for a name-brand medicine, or offer a means to use high-pressure tactics to convince a doctor to prescribe their company’s version of a drug instead of a competitor’s version or generic alternative.

Seems that so many doctors were complaining about this use of their prescription records to enable high-pressure salesmen to waste their precious clinical time, that Big Pharma became concerned that states would start applying restrictions. So the AMA decided it would be generous and give individual physicians the choice of keeping their prescribing practices off limits to drug companies and their sales forces (90,000 strong, per 2006 estimate).

The Times quotes Jamie Reidy, a former drug salesman for Eli Lilly who was fired for writing Hard Sell, an exposé of pharmaceutical industry sales practices, talking about the use of prescription data…

“It’s the most powerful tool a drug rep has, for sure.” He goes on to describe the targeting of “cowboys,” the term used for physicians who start prescribing a drug as soon as it hits the market. Drug sales reps will go see that doctor in the first week to enlist him in prescribing their newest, most expensive drugs. Reidy revealed that the prescription data for doctors is updated every two weeks.

The high cost of drugs in the U.S. is contributing significantly to our current (and worsening) health care crisis. It’s also limiting availability of Medicaid and other government programs in many states designed to insure the poor, because too much of the funding goes toward expensive, name-brand drugs instead of less expensive or generic alternatives. It’s also contributing to the overall Medicare crisis that is not solved by the maze of prescription drug benefit plans hardly anyone can understand.

There are other issues involved in the crisis related to overprescription generally, the tendency to treat all conditions with drugs rather than actual medical therapies, and the extension of our drug-dependency to increasingly younger and younger patients who may not need drug therapies at all. It’s an issue to keep an eye on for sure!

Links:

Big Pharma Spends More on Advertising than Research and Development

Doctors Object to Gathering of Drug Data

Health Spending Exceeded Record $2 Trillion in 2006

Drug Marketing Fraud: Whistle-Blower Awarded $1.6 Million