Anyone who views shows originating in the United States, whether on a television channel, YouTube or other online platforms funded by commercials would be familiar with the rampant advertising employed by global pharmaceutical and biotech companies. More recently, these ads have been exhorting viewers to ask their doctors about the drug/equipment being advertised. Because obviously, a query could lead to a prescription being written and more money in the companies’ pockets.
A report based on a recent study, published by Reuters last week, revealed that in the US alone, drug companies have been spending at least US$30 billion a year just on marketing. The report referred to it as health care advertising, but is it really? Does it have as much to do with health care as it does with keeping what is referred to as the ‘big pharma companies’ holding on to their market share and raking in huge profits?
According to Reuters, the US is the world’s biggest health care market. It is the country where the most money changes hands for the supply of health care and that includes medicines, equipment, tests, therapy and not forgetting doctors’ consultation fees. Data platform Statista reports the US as spending 17.1 percent of its Gross Domestic Product (GDP) on health care – the highest in the world. For all that, the American health care system is not the best in the world. It is far outstripped by countries like Canada, Switzerland and Denmark, which stay close to the world average of 10 percent of GDP.
And the report suggests that all of this spending is not necessarily good. Granted, advertising does help in the destigmatizing of diseases, like mental illnesses, HIV and others that are sexually transmitted. However, according to the study, the excessive marketing, targeted not only directly at consumers (patients), but to those making prescribing and purchasing decisions, can “expand or even create disease or raise false hopes by exaggerating treatment effects, for example marketing of marginally effective Alzheimer’s drugs,” and “lead to overdiagnosis, overtreatment (with associated harms) and wasted resources”.
While this is not the rule, it is known that there have been and still are instances in which the lure of dollar signs has led to unethical practices. In the past, drug companies had flooded doctors’ offices and hospitals with samples of medicines, which they hoped, or knew would lead to prescriptions being written. Some had also wooed doctors with trips, dinners and gifts to favour their products instead of their competitors’. In 2010, a whistleblower had brought a claim that the drug company Allergan was engaged in a kickback scheme, providing large quantities of samples to physicians in exchange for them prescribing that company’s drugs to beneficiaries of federal health care programmes. That same year, the US Congress passed the Physician Payments Sunshine Act, which, according to the American Medical Association, is designed to increase transparency around the financial relationships between physicians, teaching hospitals and manufacturers of drugs, medical devices and biologics. This means that pharmaceutical and medical device companies are required by law to release details of any payments they make to any doctor or hospitals for anything and that includes promotional talks, research and consulting. Patients now have the ability to go online and check against their doctors’ names to see if they have received money from any company, how much, which company and what the money was paid for. They can choose to question their doctors about it and, particularly if they notice a link between the prescriptions they are receiving and the company in question, report it or change doctors.
These checks and balances, while necessary and commendable, have not been able to completely stop underhand practices. In two separate cases earlier this year, six doctors were charged with accepting kickbacks from the drug company Insys, in exchange for prescribing a highly addictive opioid manufactured by the company. According to prosecutors, the payments were made to the doctors for speaking at educational events, which when investigated turned out to be shams. In at least two other cases, doctors were found guilty of handing their patients’ blood work to laboratories without the patients’ knowledge or consent in return for lucrative kickbacks.
Doctors take the Hippocratic Oath before they begin to practise medicine, during which they swear to, among other things, do no harm and preserve their patients’ privacy. However, some opt for get-rich-quick schemes, and big pharma companies have recognised that they need only to appeal to their greed. While the nefarious acts mentioned above only refer to doctors in the US, this happens all over the world and, sadly, has begun to place a question mark over the profession. What makes it worse is that the health care industry is lucrative enough without physicians and others losing sight of its curative value in the race for huge profits. This is a cautionary tale as most of us have been or will be under doctors’ care at some point in time: they are all only human with flaws just like the rest of us.
