The Era of "Marketing-based Medicine"

From a much longer article by Melissa Sweet, published in Crikey Online

The tactics used by the pharma industry to entrench its influence – whether with politicians, health groups or prescribers – have been hitting the headlines lately.

A story on the cover of the SMHS’s Weekend Business section (beats me why it wasn’t on the paper’s main cover) examined how the industry buys influence in Canberra, and last week Sun Dunlevy splashed in The Daily Telegraph on pharma funding of patient and other health groups. (For more about this particular story, see the bottom of the post)

Meanwhile, Dr Peter Parry, a psychiatrist and senior lecturer at Flinders University, has been investigating internal pharma documents and has come to the conclusion that we live in a world of “marketing-based medicine”. He writes:

“The larger issue is how do we face the outside world when they begin to criticize us for suppressing data…”  AstraZeneca publications manager in internal email 6 Dec 1999.

In recent years doctors and other health professionals have been exhorted to practice “Evidence-based Medicine” or “EBM”. We should prescribe to our patients the right medication based on the best available medical science. Similarly surgeons should select the right implantable prosthesis according to EBM.

However there has been a growing tide of voices claiming EBM is not what it seems, that given the multi-billions of dollars involved, the medical science system has been distorted. The big pharmaceutical companies spend around 11% to 15% on research and development, but they spend around 36% of their budgets on marketing. This influence means much of what passes as EBM, may in fact be “MBM” – “Marketing-based Medicine”.