Why Drug Marketing Rules American Healthcare and What We Can Do About it | Lydia Green | TEDxMcphs

have you ever been in a situation that seems perfect and then weeks months or years later you discover it's not as perfect as it seems you find yourself fascinating between putting on rose-colored glasses and facing up to the facts and walking away i call this state of ambivalence sitting on a fence and let me tell you if you sit on a fence long enough it gets uncomfortable my fence was my career i want to share with you my personal odyssey of enlightenment as a pharmacist and former pharmaceutical ad writer from being a wizard of white lies to being an ardent advocate for honesty in pharmaceutical marketing and if there's one lesson i want to leave you with it's this just because something sounds like science doesn't make it so when i went to massachusetts college of pharmacy i worked part-time for the president ray goslin was a pioneer in pharmaceutical marketing he suggested that i pursue a career in medical advertising because he thought it would leverage both my creative writing skills and my scientific training pharmaceutical ad writers like me and others take the science generated by drug companies and we weave it into powerful stories that make people clamor for the newest and latest drugs medical devices and treatments we do not work at pharmaceutical companies we work at advertising agencies medical education companies and pr firms retained by the pharmaceutical industry to help promote their brands i learned about the meaning of science to drug companies my first week on the job i was a writer at an ad agency in new york we were meeting with a client who had a new drug for hypertension we spent the next two hours debating how to describe the drugs mechanism of action should we describe it as being potassium conserving or sodium depleting would it seem more impressive if we spelled out the word potassium or used the symbol k plus from the periodic table i was so bored however i internalized the first lesson of medical marketing wrap everything in science in order to sell drugs the science drug companies use is not fake it's real however it is misleading because it is incomplete drug companies cherry-pick scientific facts which then are spun in a positive direction as they flow through an information pipeline the dissemination of this science may seem spontaneous however it is anything but it is planned organized and coordinated by an army of science and marketing communicators all to the tune of 30 billion dollars a year i believe drug companies have the right to market their products i believe drug companies have the right to earn profits however drug companies in america do much more than market their medicines they actually shape health care americans are less than five percent of the world population yet we consume one third of the world's 1.4 trillion dollar marketplace in prescription medicines but more disturbing than these costs is the suffering that our culture of over prescribing causes we put kids as young as five on antipsychotic medications we inflict cholesterol-reducing agents on people who don't need them and we over prescribe diabetes medications to older americans who then wind up in the hospital due to drug induced falls and fractures at the end of the day a pharmaceutical company's objective is to maximize their profits as an executive at a pharmaceutical company told me drug companies say they want their drugs used appropriately however drug companies just want their drugs used will they ever admit that publicly hell no let me show you how easy it is to skew science to sell drugs there are three primary marketing strategies that drug companies use first you can exaggerate the drug's benefits second you can expand the number of patients needing treatment and third you can minimize the drugs risks these strategies can be hard to detect because they're based on lies of a mission not outright lies the marketing of benefits actually begins at the clinical trial phase the drug company that is designing the study is the same company that at a future date hopes to profit off the sale of that drug the bar for fda approvals is actually quite low the drug company only needs to show that their drug is more effective than placebo there are times where a company compares their new drug to an existing treatment called the standard of care these generally use a non-inferiority trial design a non-inferiority trial design is a tongue twister even to a seasoned writer like me what it means is that the new drug only needs to be not worse not inferior than the standard of care let me repeat that what it means is that the new drug needs to be no worse not inferior to the standard of care i had a client who was trying to get approval for a drug for advanced pancreatic cancer the initial trial results were on promising the drug only extended life by 30 days the client however appeared unfazed he believed that we could get doctors to prescribe the drug despite its lack of efficacy i remember looking at him thinking how cold and calculated he sounded i did not however say anything because i was there to do a job not to deliver a lecture on empathy i created an ad campaign that depicted patients desperately trying to hang on for 30 days more so they could attend their daughter's wedding or their son's law school graduation the client was overjoyed with the campaign which featured the headline i want to live cancer drug marketing is an example of how advertising plays on our hopes and fears and shapes our core attitudes about sickness and health imagine if drug companies promoted cancer prevention instead of cancer treatment sometimes i ask my colleagues if they thought we were using science to full doctors i was met with blank stares and looks of total miscomprehension i realized that my colleagues felt that i was insulting their integrity so i remained on my fence not wanting to make waves let me explain another marketing strategy that helps expand the number of treatable patients i like to call this strategy supersizing today 45 percent of americans take drugs for cholesterol we spend so much money on diabetes care that congress formed a commission to investigate why when you have 25 drugs to reduce high blood sugar or 10 drugs to reduce cholesterol there comes a time where there are not enough treatable patients drug companies can only earn a profit if they supersize the patient pool imagine a pizza if 10 companies share a pizza of patience each company gets a small slice of the pie however if you supersize the pizza each company walks away with a generous slice of the profits super supersizing is more sophisticated than traditional marketing pharmaceutical companies hire doctors so-called thought leaders who represent their interests at medical conferences in scientific publishing and with the medical associations who determine how drugs are used the centers for medicare and medicaid reported that these doctors were paid 2.3 billion dollars in 2019 as recently as 25 or 30 years ago cholesterol was not an issue with the medical community today most americans believe that every adult with high cholesterol should be on a cholesterol-reducing agent i helped perpetuate this myth i wrote one of the first thought leader presentations on this topic i had to convince doctors that high cholesterol was as great a risk factor as high blood pressure or smoking for heart disease despite the fact that there was little evidence to that effect today the myth persists that high cholesterol is bad for everyone even though that is not true i finally did fall off the fence it was a night to remember i was working on a new drug for schizophrenia this drug was more effective and safer than existing treatments at least that's what we said in our marketing materials as the drug was used in more and more patients reports started to emerge that the drug caused three serious side effects morbid obesity diabetes and enlarged breasts in men the client became very concerned that these side effects would interfere with cells they approached us and asked if we could help them prove that the side effects were unrelated to the drug unfortunately the side effects were actually a byproduct of the drug's mechanism of action the client was not happy to hear this they asked us to keep looking i reached out to medical school faculty who confirmed my findings the client was still not satisfied one night my ad agency manager came to my office in tears begging me for help she was afraid that the client was going to pull the account from the agency and in one moment i was enlightened no more rose-colored glasses no more ambivalence no more fence the next day i resigned i did get a good laugh several years later because that company was fined 2.2 billion dollars for making false and misleading claims about that drug we can learn a lot from the pharmaceutical industry one thing i learned is that no obstacle is insurmountable instead of demonizing the industry we need to start imitating it we need to form our own army of science and marketing communicators our army of communicators will build a pipeline of drug and disease information that is a trusted alternative to the pharmaceutical industry we will amplify the voices of doctors without ties to industry this consortium should consist of medical and pharmacy schools physician experts and former pharmaceutical ad writers we will fund this alliance with a small fee on payments made by drug and device companies to doctors my nonprofit rxbalance was part of a national institute of health study that showed that doctors and ad writers could collaborate successfully on medical content we identified gaps in physician and patient knowledge and then we close those gaps with ad style messaging using workflows and editorial processes from pharmaceutical advertising this year i am proud to say that rx balance worked with government physicians on a campaign to make prescribing safer for older patients with diabetes countering the influence of pharmaceutical marketing on american health care is a herculean task however every journey starts with the first step what we cannot do alone we can do together i commend you to the words of the first century jewish scholar hillel if not you who if not now when it took me 30 years to get off my fence may you get off your sooner thank you

Channel: TEDx Talks

Views: 7,821

Keywords: TEDxTalks, English, Health, Advertising, Ethics, Media, Medicine, Truth

Id: Jh7rQbknPyE

Length: 15min 53sec (953 seconds)

Published: Mon Nov 23 2020