The motives of pharmaceutical companies have always been a polarizing debate amongst patients and physicians alike.  These massive institutions have the capacity to wield a tremendous amount of good with their mega-monster capabilities in research and development.  Of course with that comes an equally seismic cost that must be reclaimed somehow.  Here is where Product Marketing and Business Strategy comes in.  

In a recent article published January 13, 2011 in the American Journal of Public Health, authors describe the marketing strategy of some pharmaceutical companies as “inverse benefit law.”  In a nutshell, this means that companies will ‘push’ a drug beyond the scope of its proven purpose and outside the boundaries of the types of patients it was proven to be potentially therapeutic for in studies.  For example, if you have osteopenia (a common bone condition of weakening bones) and there exists a medicine indicated for patients with osteoporosis (a more severe form of bone weakening), you might be advised to start this prescription medication.  Doctors and patients are being convinced that we should consider bisphosphonate therapy to keep the ‘osteopenia from progressing.’  Interestingly, clinical studies have not been done on this group of patients and we don’t know if it has any value in the end.  The glaring problem with this… higher rates of side effects and potential harm with no clear medical evidence for the use in these patients.  By creative manipulation and presentation of scientific data to physicians in the medical office and through emotionally charged direct-to-consumer advertising to you in your family room, there is a greasy slope sliding into more profits for Big Pharma.    As a die-hard idealist, I would prefer to believe that this type of business does not happen in the healthcare industry, but it does.  Not every company prioritizes nor does every physician fall for these tactics, but it does exist in healthcare today.

There is no quick solution to this problem of epidemic proportions.  It will take an active role from both patients and physicians alike to avoid the allure of the ‘magic bullet’ medicine model.  We must stop feeding the mindset that a powerful pill is the answer to all our health issues.  In the decade that I have been practicing, I have seen pharmaceutical companies be put in ‘time out’ numerous times, sometimes by their own governing bodies and sometimes by the consumer.
 
There is an obvious, yet disturbing, conflict of interest when pharmaceutical companies, physicians, chemotherapy manufacturers, imaging companies and the like determine who should take certain medications, get certain testing and then profit from those choices.  Does it make sense for a sickness-based industry to potentially lose billions in revenue if its services actually healed an entire society sufficiently enough that those customers, I mean patients, didn’t need their medications or needed their medical services less and less?  My personal business strategy:  There are plenty of sick patients in need of health-based services to keep the medical industry churning for decades.  If in some fantasy, everyone became well and doctors had no patients to see, we would just have to gracefully explore the next professional pursuit on the list.  

I leave you with a comment by Upton Sinclair that just makes you think twice about the nature of greed… in any business culture.

“It is difficult to get a man to understand something when his salary depends upon his not understanding it.”