Title: States Of Health
Date: Winter 1998
Source: Retrieved on January 19, 2005 from web.archive.org
Notes: Published in Direct Action #9 — Winter 1998.

      bigger picture

      drug consumption

      loyalty drugs

      patient power?

      virtual drugstores

The US is ‘leading the way’ in hard-sell prescription drug marketing. Bearing in mind that what starts over there usually ends up over here, welcome to the future of health care...

New health adverts are appearing on TV across America. No more wheezing victims claiming the benefits of cough syrups or sad people suffering with trapped wind. The new generation of adverts is about showing healthy people enjoying a newly wonderful life. Why are these people so happy and healthy? Because they are taking new wonder drugs -and there are now plenty to choose from.

So what’s the big deal? Drug adverts that make exaggerated claims are hardly new. The big deal is that the drugs concerned are prescription drugs, only available through the doctor. Until last year, named prescription drugs could not be advertised on US TV. Now, under the guise of free market deregulation, the laws have been relaxed. Australia, South Africa and Latin America are set to follow suit. Huge pharmaceutical conglomerates such as Britain’s Glaxo-Wellcome are pouring money and effort into a behind-the-scenes lobbying campaign to get the law changed in Europe.

This new direct-to-consumer advertising for prescription drugs is causing a marketing revolution in the US. Spending on prescription drugs ads is expected to top $1 billion this year, making it bigger than beer advertising. As a spokeswoman for one of the leading marketing companies gushed “...drugs ads are what cigarette ads and alcohol ads were ten years ago. Almost every agency is developing a health-care team to meet the demand from drug companies.”

A large chunk of this new market is about so-called lifestyle drugs. Drugs of dubious or limited medical benefit are being marketed as if they are capable of transforming lives. Take the drug and you are buying into ‘a whole new way of life’. And the latest trend.

But it is not just lifestyle drugs that companies are hoping to cash in on. Drugs aimed at people suffering from serious illnesses are now being branded in the same way as Coca-Cola.

bigger picture

The advertising of prescription drugs is part of a wider shift towards direct-to-customer advertising. Companies are increasingly aware that, even if their product is not sold direct to the public, it still pays to advertise. One of the pioneers of direct-to-customer advertising was the computer processor maker Intel.

The decision by Intel to embark on an advertising campaign was greeted with scorn by the rest of the industry. Why advertise goods that would largely only be bought by companies making computers? (Note, Britain is the only place with a big ‘peripherals’ and ‘home build’ PC market, due to artificially high PC prices). However, what Intel knew was that, faced with the bewilderment of constantly changing computer technology, consumers had no real way of evaluating what they were about to buy. Intel would provide something people could identify with and ask for when they were buying. The rest is marketing history.

It is a lesson not lost on drug companies. Even if your products are not bought directly, brand recognition is still vital for ‘effective marketing’. The central aim now is to make once obscure prescription drugs into established household names. Hence the pressure to relax the rules governing advertising.

drug consumption

The drug companies were right; advertising certainly does pay. A study in the American magazine Prevention found that 90% of the 1200 people had seen a prescription drug advert and a third had visited their doctor as a result. Remarkably, 80% of doctors agreed to prescribe the drug. Furthermore, a third of patients who saw an ad for medicine felt better about its safety, were more likely to take it, and were reminded to re-order their prescription. All through prescription drug adverts. Little wonder that drugs companies, downsizing everywhere else, are reaching for the chequebook when it comes to advertising budgets.

The early advertising success is already altering the way companies operate. In the past, the drug companies ran clinical trials aimed at finding cures. Now, clinical trials aimed at improving brand recognition are becoming increasingly common. Brand differentiation is rapidly replacing drug effectiveness as the first priority of the drugs industry.

In terms of the actual products, the changes are rapid. Packaging and promotion begin to take precedent over content, and research money is being targeted at finding ways to enable drug companies to make exaggerated marketing claims. The market is getting increasingly cut-throat.

A more convenient delivery method (e.g. tablets or pads rather than injections), or a combination which reduces side effects, anything is enough to let loose the marketing pack. Within days, the airways are flooded with adverts pummelling home the message that (BRAND NAME!!!) the new improved drug (BRAND NAME!!!) causes less drowsiness (BRAND NAME!!!).

The results so far are bigger profits. For instance, the makers of Clariton were able to steal a march over competitors through claims that a new version caused less drowsiness. The adverts hit the screens, and Clariton now sells for $1.90 a pill, even though equally effective drugs are available for just a few cents.

loyalty drugs

Media advertising of drugs has opened the door to a whole new world. Drug companies are now designing promotion packages aimed at exploiting the fears of the chronically ill and the aged. Omnicom, the US drug giant, has set up Acuity, a special division which will create special regimes to cater for individual patient needs. The main selling point is that they will encourage patients to take their drugs and, in addition, advise on special diets and programmes. Behind the caring gloss, there is a candid streak. Acuity themselves even boast that the caring programme is nothing more than a loyalty package aimed at ensuring that long-term sufferers stay with their product.

A particularly chilling aspect of the move to prescription advertising is the amount of information being gathered by the drug companies. The adverts offer free advice. The free phone calls and visits to web sites have provided information which amounts to a marketing gold mine. Drug companies will increasingly ‘know their customers needs before they do’. In short, they will be able to manipulate people’s health fears for profit.

patient power?

There was no mention of the word profit in the campaign to get the laws on drugs advertising relaxed. The slogan on every company director’s lips was “patient power”. They argued that prescription advertising would educate the public. With greater awareness of what’s available, people would be able to make an informed choice, thus increasing the power of the patient and diminishing the power of the doctor.

The argument is, however, complete nonsense. Study after study has shown that private provision is less efficient and that it diverts money from health care towards shareholders. In Britain, under mainly state provision, spending stands at $1,347 per person on health care. Under the mainly private system in the US, this figure is $4,090 per person. Yet the quality of health care in both countries is about the same. That is, apart from the fact that some 50 million people in the US have no health cover.

In the crazy world of capitalism, such considerations count for little. Reality is swept aside by the power of free market rhetoric. It seems that the power of the drug companies to exploit the old, the sick and the vulnerable in the name of profit is set to increase.

Hard-hitting advertising creates and stimulates demand. This is what the drug companies really mean by patient power.

What about patient power in the sense of a person’s right to control his or her own health? To advocate such a thing you would have to oppose all the current health care trends. What about responsibility for personnel and collective health being too important to be handed over to the state and big business? To advocate such a thing you would have to be nothing short of revolutionary.

virtual drugstores

Since the shift to large-scale media advertising coincides with new advertising technology, it is not surprising that multinational drug companies are spending increasing amounts of money promoting themselves and their products on the Internet. Internet-based drug companies can get around laws relating to drug advertising in individual countries. A rapid new market area is the sales of what would otherwise be prescription drugs over the Internet, often at massive profits. Perhaps the most famous example is the anti-impotency pill Viagra, which has been reported selling at upwards of Ł50 a pill. Often companies attempt to give themselves an air of medical authority by asking the customers some rudimentary health questions before demanding credit card numbers.

The World Health Organisation passed a resolution in May 1997 calling for tighter controls of the selling of drugs and quality of information provided on the Internet. However, practice so far suggests this is a non-starter. As use of the Internet continues to grow, it is likely that drug companies will devote more and more resources to its use to promote their wares simply because it is free from any form of regulation.