The pharmaceutical industry spends almost twice as much on the marketing and promotion of drugs than on research and development, according to a new analysis in this week's PLoS Medicine.
In their analysis of data from two market research companies, IMS and CAM, Marc-André Gagnon and Joel Lexchin (York University, Toronto, Canada) found that US drug companies spent US$57.5 billion on promotional activities in 2004, the latest year for which figures were available.
In comparison, the National Science Foundation reported that in 2004 the amount of industrial pharmaceutical research and development (including public funds for industrial research and development) was US$31.5 billion in the United States.
For the last 50 years, say the authors, there has been an ongoing debate as to which image of the drug industry is most accurate. The industry promotes a vision of itself, say the authors, as "research-driven, innovative, and life-saving," but the industry's critics contend that the drug industry is based on "market-driven profiteering."
The findings of their study, say Gagnon and Lexchin, "confirms the public image of a marketing-driven industry and provides an important argument to petition in favor of transforming the workings of the industry in the direction of more research and less promotion."
The types of promotion that were included in the US$57.5 billion figure included free samples, visits from drug reps ("detailers"), direct to consumer advertising of drugs, meetings with doctors to promote products, e-mail promotions, direct mail, and clinical trials designed to promote the prescription of new drugs rather than to generate scientific data (these are known as "seeding trials").
The authors believe that their figure of US$57.5 billion is likely to be an underestimate. "There are other avenues for promotion that would not be captured by either IMS or CAM,” they say. These avenues include the ghostwriting of articles in medical journals by drug company employees, or the off-label promotion of drugs.
Citation: Gagnon MA, Lexchin J (2008) The cost of pushing pills: A new estimate of pharmaceutical promotion expenditures in the United States. PLoS Med 5(1): e1.
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York University
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In the era of systematic reviews, does the size of an individual trial still matter?
Given that individual trials rarely provide definitive answers to a clinical research question, Edward Mills, Diane Elbourne and Gordon Guyatt debate whether sample size calculation for an individual trial still matters in this week’s PLoS Medicine.
Citation:Guyatt GH, Mills EJ, Elbourne D (2008) In the era of systematic reviews,
Does the size of an individual trial still matter? PLoS Med 5(1): e4.
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PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-01-mills.pdf
CONTACT:
Edward Mills
McMaster University
Department of Clinical Epidemiology and Biostatistics
53 Dearbourne Ave
Hamilton, Ontario M4K1M6
Canada
emills@mail.cihhrs.org
Gordon Guyatt
McMaster University
Department of Clinical Epidemiology and Biostatistics
53 Dearbourne Ave
Hamilton, Ontario M4K1M6
Canada
guyatt@mcmaster.ca
Diana Elbourne
London School of Hygiene and Tropical Medicine
Medical Statistics Unit
London
United Kingdom
Diana.Elbourne@lshtm.ac.uk
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