Featured Research

from universities, journals, and other organizations

Inverse benefits due to drug marketing undermine patient safety and public health, study finds

Date:
January 16, 2011
Source:
University of Texas Medical Branch at Galveston
Summary:
Drugs that pharmaceutical companies market most aggressively to physicians and patients tend to offer less benefit and more harm to most patients -- a phenomenon described as the "inverse benefit law," according to new research.

Drugs that pharmaceutical companies market most aggressively to physicians and patients tend to offer less benefit and more harm to most patients -- a phenomenon described as the "inverse benefit law" in a paper from the University of Texas Medical Branch at Galveston.

Published online on Jan. 13 in the American Journal of Public Health, the article explores recent withdrawals of blockbuster drugs due to safety concerns and finds a clear pattern of physician-focused marketing tactics that ultimately exposed patients to a worsening benefit-to-harm ratio. Potential patient safety and public health implications include unnecessary exposure to adverse side effects, high medical costs and competition for scarce resources.

"This is not a random occurrence, but rather a repeating, planned scenario in which drugs, discovered with good science for a specific set of patients, are marketed to a larger population as necessary, beneficial and safer than other alternatives," said co-author Dr. Howard Brody, a professor and director of the Institute for the Medical Humanities at UTMB Health. "Marketers are just doing their jobs. However, the reality is that for most new drugs, safety and efficacy are scientifically proven for only a small subset of patients. It's time for physicians to take a stand and not prescribe them so readily."

The inverse benefit law, coined by the authors and inspired by Hart's inverse care law (1), is manifested in marketing techniques commonly deployed to extend a drug's use beyond the proper evidence base. Brody and co-author Donald W. Light, a professor at the University of Medicine and Dentistry of New Jersey, identify these strategies and illustrate the "law" with recent examples:

  • Guidelines that reduce diagnostic thresholds and rely on surrogate endpoints -- as seen in the steady lowering of blood glucose levels at which diabetes should be diagnosed to support glitazone drugs. Or relying on statins to lower cholesterol versus having a proven impact on the hard endpoint of decreasing heart disease incidence.
  • Exaggerated safety and efficacy claims -- as many as 140,000 cases of serious coronary disease in the U.S. might have been caused by rofecoxib, a COX-2 inhibitor, that was broadly marketed as safer and more effective than standard nonsteroidal anti-inflammatory drugs.
  • "Disease mongering" -- Osteopenia, once considered a non-disease state in patients who had not lost enough bone density to be diagnosed with osteoporosis, has now turned into a disease itself, in hopes of convincing physicians and patients that biphosphonate drug treatment will prevent their "disease" from progressing.
  • Encouraging unapproved uses -- three of five prescriptions for antipsychotics are for off-label use, even though 75 percent of those prescriptions lack evidence of benefits but expose patients to harm. Recent examples include gabapentin and olanzapine.

"While we looked only at marketing directed toward physicians, direct-to-consumer advertising plays a critical role in driving demand for a drug by patients who fall outside the group that might truly need it, and pressuring physicians to prescribe it more readily," said Brody. "European countries are now debating whether to join the U.S. and New Zealand in allowing DTC advertising and we hope that our work could help inform that discussion."

Brody and Light recommend a series of remedial actions, including: restrict writing usage guidelines to groups free of commercial conflicts of interest; independently fund and design trials focused on safety and efficacy; and create a neutral agency (e.g., a branch of the National Institutes for Health) to conduct drug trials, including comparative effectiveness research to improve evidence-based prescribing.

The authors point to recent efforts such as the National Physicians Alliance's Unbranded Doctor Campaign and The Physician Payment Sunshine Act as positive steps toward a safe marketplace where physicians and patients access valuable, effective drugs.

"There is an unintended, but direct conflict between pharmaceutical marketing and public health," said Brody. "Physicians should approach commercial marketing by pharmaceutical companies with a critical eye. Future reform polices should look to reduce, minimize and limit these practices. Patients can also play an important role by being more skeptical of drug ads … and remember, the most important directive in them is to 'talk to your doctor'."

(1) Hart JT. The Inverse care law. Lancet. 1971;1 (7696); 405-412.


Story Source:

The above story is based on materials provided by University of Texas Medical Branch at Galveston. Note: Materials may be edited for content and length.


Cite This Page:

University of Texas Medical Branch at Galveston. "Inverse benefits due to drug marketing undermine patient safety and public health, study finds." ScienceDaily. ScienceDaily, 16 January 2011. <www.sciencedaily.com/releases/2011/01/110113213129.htm>.
University of Texas Medical Branch at Galveston. (2011, January 16). Inverse benefits due to drug marketing undermine patient safety and public health, study finds. ScienceDaily. Retrieved August 27, 2014 from www.sciencedaily.com/releases/2011/01/110113213129.htm
University of Texas Medical Branch at Galveston. "Inverse benefits due to drug marketing undermine patient safety and public health, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/01/110113213129.htm (accessed August 27, 2014).

Share This




More Health & Medicine News

Wednesday, August 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

WHO Calls for Ban on E-Cigarette Sales to Minors

WHO Calls for Ban on E-Cigarette Sales to Minors

AFP (Aug. 26, 2014) The World Health Organization called Tuesday on governments should ban the sale of e-cigarettes to minors, warning that they pose a "serious threat" to foetuses and young people. Duration: 01:44 Video provided by AFP
Powered by NewsLook.com
Have You Ever Been 'Sleep Drunk?' 1 in 7 Has

Have You Ever Been 'Sleep Drunk?' 1 in 7 Has

Newsy (Aug. 26, 2014) A study published in the journal "Neurology" interviewed more than 19,000 people and found 15 percent suffer from being "sleep drunk." Video provided by Newsy
Powered by NewsLook.com
Does Medical Marijuana Reduce Painkiller Overdose Deaths?

Does Medical Marijuana Reduce Painkiller Overdose Deaths?

Newsy (Aug. 26, 2014) A new study found fewer deaths from prescription drug overdoses in states that have legalized medical marijuana. But experts disagree on the results. Video provided by Newsy
Powered by NewsLook.com
Official: British Ebola Sufferer Receiving Experimental Drug

Official: British Ebola Sufferer Receiving Experimental Drug

AFP (Aug. 26, 2014) A British nurse infected with Ebola while working in Sierra Leone is being given the same experimental drug used on two US missionaries who have recovered for the disease, doctors in London say. Duration: 00:44 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins