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Pharmaceutical Shocking Facts

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Pharmaceutical Facts
  • The Research-based pharmaceutical industry spends more on marketing and administration than it does on research and development. (Families USA)
  • U.S. Drug spending increased 17.1% to $154.5 billion dollars in 2001. One-quarter of this increase was due to a shift to the use of more expensive drugs.  (National Institute for Health Care Management)
  • The top selling drug in 2001 was Lipitor. Increase in Lipitor sales contributed more than any other single drug to the increase in drug costs that year (NIHCM). The effect of Lipitor on cardiovascular morbidity and mortality remains unknown.
  • Pharmaceutical industry profits were 18.5% of revenue in 2001. For the remainder of Fortune 500 companies, median profits were 3.5% (FamiliesUSA).
  • Since 1995, R&D staff of U.S. brand name drug companies have decreased by 2%, while marketing staff have increased by 59%. Currently, 22% of staff are employed in research and development, while 39% are in marketing. (PhRMA Industry Profile 2000; percentages calculated by Sager and Socolar)
  • In a study by Avorn, et al, forty-six per-cent of physicians reported that drug reps are moderately to very important in influencing their prescribing habits (Am Journal of Med, 1982).
  • In a study by Lurie, et al, one-third of medical residents reported that they change their practice based on information provided by drug reps (Journal of Gen Int Med, 1990).
  • In a study by Steinman, et al, 61% of medical residents stated that industry promotions did not influence their own prescribing, but only 16% believed other physicians to be similarly uninfluenced.(Am Journal of Med, 2000)
  • Two and one-half billion dollars were spent on advertising to consumers in 2000. Increases in the sales of the 50 drugs most heavily advertised to consumers were responsible for almost half (47.8%) of the $20.8 billion increase in spending in 2000.(NIHCM)
  • In 2000, Merck spent $161 million on advertising for Vioxx. That is more than Pepsico spent advertising Pepsi. ($125 million), and more than Anheuser-Busch spent advertising Budweiser.($146 million). The increase in Vioxx sales in 2000 accounted for 5.7% of the 1 year increase in drug spending. (NIHCM)
  • A study by Westfall, et al, found that 96% of physicians and staff had taken samples for personal or family use in the preceding year. (JAMA, 1997)
  • According to industry estimates, drug companies spent $15.7 billion dollars on promotion in 2000. $7.2 billion dollars worth of free samples were distributed that year(IMS Health).
  • A study by Chew, et al , found that in the treatment of hypertension, over 90% of physicians would dispense a sample that differed from their preferred drug choice. (JGIM, 2000)
  • The AMA generates $20 million in annual income by selling detailed personal and professional information on all doctors practicing in the United States to the pharmaceutical industry (NY Times, November 16, 2000).

News roundup  From British Medical Journal


Only 6% of drug advertising material is supported by evidence

Heidelberg Annette Tuffs

A new study of the advertising material and marketing brochures sent out by drug companies to GPs in Germany has shown that about 94% of the information in them has no basis in scientific evidence.

The study, carried out by the Institute for Evidence-Based Medicine, a private independent research institute in Cologne, evaluated 175 brochures containing information on 520 drugs, which were either sent by post or handed out to 43 GPs since last June. The study was published in this month’s issue of the drugs bulletin Arznei Telegramm (2004;35:21-3;

About 15% of the brochures did not contain any citations, while the citations listed in another 22% could not be found. In the remaining 63% the information was mostly correctly connected with the relevant research articles but did not reflect their results. Only 6% of the brochures contained statements that were scientifically supported by identifiable literature.

The evaluation was done by two specially trained and independently acting reviewers. In cases of doubt a third reviewer was involved.

"This is the first study in Germany evaluating the quality of drug advertising material," says Thomas Kaiser, a scientist at the institute who published the study together with Peter Sawicki and other colleagues.

He points out that the advertising material presents distorted images of the drugs’ profiles. The article lists several examples of misrepresentation: medical guidelines from scientific societies are misquoted or changed, the side effects of drugs are minimised, groups of patient are wrongly defined, study results are suppressed, treatment effects are exaggerated, risks are manipulated, and effects of drugs were drawn from animal studies.

The authors warn that such a high amount of misinformation puts patients’ health at risk. Studies from other countries have shown that doctors tend to base their decisions on the information and advertising material sent out by drug companies. Therefore, the authors conclude, an independent institution should be established to monitor the content of such material.

Ÿ The German drug industry has decided to tighten the rules in its self regulatory code on relations between the industry and the medical profession with regard to cooperation in clinical studies and attendance at conferences that are funded by drug companies.

The German Association of Research Based Pharmaceutical Companies in Berlin announced that its members have set up an independent tribunal in Berlin. Members of the tribunal will be chosen by drug companies and doctors’ and patients’ groups but will not be elected representatives of those bodies. Like a court, the tribunal will be able to punish companies that break the rules, imposing fines of up to €50 000 (34 000; $63 000) or, in the case of a second offence, up to €250 000. Anyone will be allowed to notify the tribunal of possible offences.

The initiative was the industry’s reaction to the German government’s threat to install an executive against corruption. Doctors’ associations have also tightened their rules on corruption.

BMJ  2004;328:485 (28 February), doi:10.1136/bmj.328.7438.485-a