Here are some UK facts and figures to consider
- The current cost to the NHS of pharmaceuticals is 10 billion pounds a year, roughly 30 million pounds a day.
- It is very hard to get robust data on the amount spent on marketing in the UK by pharmaceutical companies. One of the problems is defining what activity should be deemed as marketing! We simply argue that all contact is marketing or why else would these, for profit companies bother?
- It follows that the industrys involvement in 90% of all post grad education should be seen as marketing activity. The industry sets the agenda, pays the speakers - “he who pays the piper calls the tune”
- The industry makes much of much of being "research based" but 80% of research is into the profitable “me too” products. Real innovations need no marketing.
- Despite lack of real drug innovation there are currently 8000 sales representatives promoting to about 60 000 working NHS doctors. This is means that 1 representative works full time promoting to 7.5 doctors! Not a bad teaching ratio. As we have no information from the companies on the level of contact we have attempted some crude calculations. If we assume that each representatives sees 5 doctors a day and then also assume that 20% of doctors see no representatives at all. This suggests that those doctors who meet representatives, do so on a virtually daily basis. Should the industry want to correct this figure we would happily do so.
- One estimate from Glasgow University's Robertson Centre for Biostatistics Is that £10 000 per year is spent per doctor on marketing.
The ABPI is the trade organisation of the Pharmaceutical Industry in the UK and is entirely funded by contributions of the industry. It speaks on behalf of the industry and operates the “code of practice.” This code, however, is entirely voluntary and the ABPI have no real powers or censor over companies. Any breaches of the code must be reported to the APBI. This leaves a £10 billion business with no active policing of its marketing activity. Despite the daily contact with health professionals only a handful of complaints come from doctors. Odd don’t you think?
A major issue is that most health professionals are oblivious to the existence of this code. The core theme is that the contact should be educational with any hospitality being secondary. Um!! In a recent article its director wrote the ABPI "is recognised internationally as a gold standard on which many other codes are based”. Um!! Read these true confessions
Some terms for you NFL activists
- “Astroturfing”. This is term describe how Pharma Companies use and support patient groups. Get your message across by using a charity- great credibility
- "neo drug". A drug pretending to be different from its preceding version. Faster acting, less sedating that sort of thing. This claims are generally complete cobblers.
- “Evergreening”. Your highly profitable drug is coming off patent and cheaper generic versions can made.Oh no, we stand to lose millions. Never fear,shortly before patent expiry the company produces the “neo” drug. This is faster acting and 5% cheaper. The company therefore suggests switching all current patients on to the “neo” drug. When the original drugs loses the patent protection, all patients are now on the "neo" drug. Hurrah,another decade of inflated costs to the NHS.
- “Me Too”. This is a product that we already have effective versions of in the market eg new Statin or a new antihistamine. The motivation is to get a cut of the big money action.
- “Switching.” This activity involves offering to switch all patients onto the company's medication. This "switching" is paid for by the industry and patients consent is not sought. This happens all the time with the “neo” products and is part of evergreening activity.
- “Publication Bias”. Consider 10 studies of which 5 show a positive result and 5 a negative result for a drug. Supress negative results and publish 5 positive studies. A wonder drug is born. We have no trial obligatry registration ,therefore, companies potentially publish the studies that they want.
- “Trial Registration”. We campaign for trial registration so that we can limit positive publication bias.
- “Regulatory Capture”. The concept that the regulators are so close to the industry that they are unable to regulate the industry.