Better Living Through Chemistry

The January 11, 1999 issue of Time magazine is a special issue titled "The Future of Medicine." One might be very concerned about biases in coverage on this topic if they were to find out that this issue was sponsored by businesses in the medical industry, who obviously have a vested interest in coverage of the world of medicine. It might be even more disturbing if one single company were the sole sponsor of the issue. And that is what has happened. The entire issue about the future of medicine was sponsored by Pfizer, Inc., the pharmaceutical company that brought you Viagra.

I delved into the issue expecting every article to be about miraculous new drugs and medications that would become available in our glorious future, but was surprised to see that the majority of the articles were about genetics, genetic engineering, gene therapy, etc. But the connection became more apparent with the subheading for the article entitled "Drugs by Design": "Thanks to genetics, the pharmaceutical industry is exploding with new ideas." This link is made more explicit by this quote from an article on Pfizer's web page:

"Alliances between major pharmaceutical companies and biotech firms are mutually beneficial, as the discovery of new therapeutic entities and their testing, approval, and marketing create reasons for shared ventures and synergies of...`tremendous commercial potential as well as extraordinary scientific achievement.'"

As Pfizer is a corporation, oriented solely towards profit, one need not wonder if their main interest is in the "commercial potential" or the "scientific achievement."

The only other explicit bias I noticed was an article called "Brave New Farm," which spoke of the tremendous potential of genetically engineered crops, and was quite critical of activists who were against the use of genetically-engineered foods.

This issue of Time was nearly 1/3 advertising. Each ad was a feel good ad about Pfizer, Inc., or an ad for one of their many medications. There was also a one page ad that was an article (an "advertorial") written by the Pfizer CEO called "Pfizer Forum"; the fine print describes Pfizer Forum as an "advertising series sponsored in the interest of encouraging public discussion on policy questions and featuring a wide variety of views from leading policy experts." Evidently the Pfizer CEO is a leading policy expert. Pfizer Forum is most frequently found in "The Economist," the British magazine for elite investors, and other economic journals. Some of the past titles are quite indicative of the editorial stance of PF authors: "The Case for Private, Mutual Health Care"; "Health Care: Growth Sector of the Future?"; "Intellectual Property Rights and International Trade"; and "Capitalism Can Save Your Job."

This particular "Pfizer Forum" basically argues against any rash decisions to reform American health care, despite rising costs. Instead, the author states that we ought to "introduce policies that make the market work better." He bases these claims on Pfizer's "decades of experience in healthcare systems around the world, which has given [it] a unique global perspective on the right and wrong way to reform healthcare." Government reforms will both fail to bring down prices and will "fail to provide the best quality care" (although I'd argue that neither the current system, nor even an idyllic government-reformed system would provide the "best" quality care; it's an empty argument). The rest is typical pro-business nonsense about the need for incentives for discovery, the idea that without protection of intellectual property, new drugs won't be developed, and that regulation will restrict "choice" and "freedom."

So after analyzing Pfizer's media, I thought I should look at the company itself. It is quite interesting how a company's own webpage, which you'd think would only contain positive information about the company, tends to make me both amused and nauseous. Pfizer's was no exception.

Pfizer's most recent success is Viagra, the blood-pressure medication now used to treat male impotence. Pfizer also makes about 50 other medicines and toiletries for all kinds of ailments, from muscle pain to dry eyes to depression to diabetes. They even have a few products for animal health.

Pfizer is seen as a real up and coming company, its growth fueled by "direct-to-consumer advertising of prescription drugs." This practice was forbidden for decades, but restrictions have been lifted in recent years.

I'll just toss out some quotes, from the webpage itself, which make me nervous:

- "The marketing equation is simple: If patients primed by TV commercials ask doctors, swayed by sales visits, about drugs with compelling clinical trial results, lots of prescriptions will get written."

- "At Pfizer, marketing infuses every aspect of drug development and delivery. Marketers, as much as researchers, dictate which drugs make it out of the lab. The salespeople have a heavy hand in guiding all clinical research, once the sole province of the guys in the white coats."

- "Selling drugs is more complicated than selling, say, soap. You need to interest consumers, but first you must win over doctors. Though it ranks only fourth in worldwide drug sales, Pfizer deploys the largest sales force in the industry--5,400 marketers pushing free samples. Their ranks are filled with gung-ho former military men and women urged to ever greater efforts with the carrot-and-stick of hefty bonuses and multiple quotas."

- "Since then Pfizer has expanded its sales ranks by more than 50% in just two years. `Marketing used to be aimed just at doctors,' says Myron Holubiak, the new president of Roche Laboratories Inc. and a former consultant to Pfizer. "Now companies need to make meaningful statements that matter to all the stakeholders: doctors, health systems, patients, and managed care organizations. Pfizer's been very successful at that."

- "Pfizer's aggressiveness has occasionally gotten it into trouble. Two years ago the U.S. Food and Drug Administration caught the sales force using a brochure advocating unapproved or "off-label" uses for Zoloft, the antidepressant that competes with Lilly's Prozac. The Pfizer force was pushing Zoloft as a pick-me-up for, among others, patients who have just survived a heart attack--even though studies had found that taking Zoloft might cause further heart problems. Pfizer was forced to publicly recant."

So there you have it ladies and gentlemen, the future of medicine: marketing, marketing, marketing.

Sources: Extra! Jan/Feb 99, Forbes Jan 11 99, Pfizer webpage, Time Jan 11 99