Pharmaceutical Marketing and the Invention of the Medical Consumer

Applbaum demystifies some of the assumptions at work in the "culture of marketing," toward the goal of explaining contemporary disease mongering.

It is often said that leading drug companies now spend more on mar research and development [1].While such contemporary pharmace practices are sometimes believed to be a modern phenomenon, the continuation of 19th-century patent medicine advertising."Nostrumnovelist Henry James dubbed them, are noted in the history of adver the leading spenders on, and foremost originators of, advertising te Nostrum sellers pioneered print advertising, use of trademarks and "pull" or demand-stimulation strategies, and even the design and co medical almanacs that functioned as vehicles for promotion of disea James's psychologist brother, William James, was so exasperated by advertisement abomination" that in 1894 he declared that "the auth advertisements should be treated as public enemies and have no m page 235 in [4]).
There is no doubt that drug company discoveries have profoundly im capacity to treat illness.But pharmaceutical marketing is more close consumer marketing in other industries than with medicine, for whic are not trivial.Once we view pharmaceutical industry activities in thi disentangle industry's in uence on contemporary medicine.Becaus owe corporations our wealth and well-being, we tend not to question fundamental practices, and they become invisible to us.What follow demystify some of the assumptions at work in the "culture of market of explaining contemporary disease mongering.

Beliefs about the Free Market
There are three beliefs commonly associated with the "free market."PPT

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PNG larg e TIFF orig in human beings are creatures of limitless but insatiable needs, wants second is that the free market is a place where these needs might b the exercise of free choice.The last of these beliefs is that the sures innovation in all industries is unfettered competition in the market.

Insatiable needs
The anthropologist Marshall Sahlins theorizes that the belief in unlim in the West, and stems from the Christian notion of "fallen man" as su says Sahlins, in a peculiar idea of the person "as an imperfect creatu desire, whose whole earthly existence can be reduced to the pursu and the avoidance of pain" [5].A historical and philosophical examin marketing shows that an assumption of boundless needs and wants marketing theory.In this sense, marketing can be regarded as the in this view of human nature.The marketer's challenge is to translate t into pro ts.
Sahlins also points out that "in the world's richest societies, the subj lack increases in proportion to the objective output of wealth" [6].In richer we get, the more we want.One explanation of this paradox lie marketing activities are instrumental in getting us to think more abou Marketers and advertisers project and re ect back to us our discon quo.Americans are said to spend, on average, three years of their li television advertisements, and the e ect is that they are conditione more.According to the advertisements, the viewer's personal anxie dissatisfactions are best addressed by consumption.This same mes of much pharmaceutical advertising.

Lifestyle choices
In a consumer society, when individuals make choices toward the sa needs and wants, they experience this as constructing their own ind This special consumer identity is what people refer to when they use though they may not realize the consumerist implications of the wor provide a solution to the problem of unlimited needs and wants, whi enhancing free choice and the construction of lifestyle.
In pharmaceuticals speci cally, "lifestyle drug" marketing technique 1980s and 1990s for cosmetic and sexual enhancements [7,8].The been broadened to include other areas of medicine.The campaigns cosmetic and sexual enhancements were focused on expanding pe these products, and in this respect were a simple extension of custo conduct that had existed for over half a century.The crossover to cu occurred with psychotropic drugs, which have a very wide range of granting the marketer latitude in reinterpreting their value back to th example, one class of antidepressants, the speci c serotonin reupt marketed for eight distinct psychiatric conditions, ranging from socia obsessive-compulsive disorder to premenstrual dysphoric disorder marketing" has now extended to the promotion of many of the block drugs" intended for daily, lifelong consumption, such as drugs for al acid re ux.
As a result of this sequence of events, industry opened the treatmen body-the nal frontier-to the same logic that governs all other ma the antidepressant market, the "distribution channel captain," as ma predominant competitor, ends up sailing the serotonin reuptake cha reuptake inhibitors) or the norepinephrine reuptake channel (the ch norepinephrine reuptake inhibitors) may yet be determined by mark medical jockeying.

Competition among drug companies yields innovation
It is an article of faith among free market devotees that breakthroug paternalistic expert systems such as medicine but from industrial co rms are committed to producing medications to treat diseases-as medical science-this argument has some authority.But once a rm driven by marketing-the case for most companies in most industrie then innovation comes to mean an elaboration of meaningless di e of comparable "me too" products."If marketing is seminally about an Theodore Levitt, one of the towering gures of marketing and forme Business Review, " it is about achieving customer-getting distinction b you do and how you operate" [9].More harmfully, expanding and alt perception of disease is just as e ective, and evidently a lot easier, cures.
An assumption of boundless needs and wants is at the heart of From Patients to Medical Consumers Since, in a consumer society, we see ourselves as individuals and a we exercise consumer choice, it is not di cult for pharmaceutical co privatized health-care deliverers to convince us that it is empowerin not as patients but as consumers.This conversion from patient to co the way for the erosion of the doctor's role as expert.A startling repo described in a recent New York Times article: "For a sizable group of and 30's, deciding on their own what drugs to take-in particular, sti antidepressants and other psychiatric medications-is becoming th their abilities and often skeptical of psychiatrist's expertise, they cho own research and each other's experience in treating problems like medical degree, in their view, is useful but not essential" [10].This ph article suggested, is "driven by familiarity" with the drugs.The emerg potentially dangerous situation demonstrates an unchecked expan industry into an already accepted mode of thought-that "every min as the article reported, can and should be remedied.
Promoting consumer familiarity with drugs is one example of the ver the pharmaceutical industry.This in uence extends to clinical trial a research publication, regulatory lobbying, physician and patient edu advertising and point-of-use promotion, pharmacy distribution, drug legal and ethical norms by which company practices themselves are Actors traditionally found outside the "distribution channel" of the m incorporated into it as active proponents of exchange.Physicians, a leaders, patient advocacy groups and other grass roots movements organizations, public health bodies, and even ethics overseers, thro another, have one by one been enlisted as vehicles in the distributio of patients in the distribution chain fundamentally changes their role medical care to active consumers of the latest pharmaceuticals, a ro to support industry pro ts.

Ethical Justi cation for Marketing
Because illness is one of the most tangible forms of su ering, the ph industry, more than other industries, can link its marketing activities The result is a marriage of the pro t-seeking scheme in which disea opportunity" to the ethical view that mankind's health hangs in the b and consumers in the West to some extent share a common vision o terms of their satisfaction.This apparent complicity helps even the m marketers trust that they are performing a public service.Pharmace managers that I speak to signal this when they characterize their en public as "doing good while doing well." These managers also see nothing wrong with integrating doctors, p players into the drug distribution channel.On the contrary, they say management, making it professionally principled and tactically astut regard the incorporation of consumers into the channel as ethical b needs can best be determined and satis ed, conferring upon them determination through choice.
But this choice is an illusion.For in our pursuit of a near-utopian prom we have, without realizing it, given corporate marketers free reign to View Article Google Scholar 1.

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true instruments of our freedom: objectivity in science, ethics and fa and the privilege to endow medicine with the autonomy to ful ll its o bene t of the sick.
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