PharmedOut Newsletter, December 2014

Recent Project News

  • On November 13, Dr. Fugh-Berman discussed physician phone app Epocrates in the Vox article "The insidious new ways Big Pharma is manipulating your doctors' drug choices". She said, "few physicians know that every time they look something up on Epocrates, information gets sent back to a pharma vendor ... Affecting information flow is pharma's best covert strategy ... This means that health-care providers don't know about non-pharmacologic therapies, doctors over-treat, and that they are much better versed on the benefits of drugs than they are on the harms."
  • On November 22, Dr. Fugh-Berman was quoted in part 2 of the San Jose Mercury News feature on psychiatric drugs and foster kids. “People are more receptive to messages of any kind when they’re eating," she said about drug company-sponsored lunches and speaker dinners. "Food is the great lubricant.” 
  • Footage of FDA's female sexual dysfunction workshop in October, including the PharmedOut testimony that we covered last month, is now available online.
  • PharmedOut's Resource of the Month: Need more CME before the end of the year? Check out our list of pharma-free online options.
December's PharmedOut Fodder: There's a (Pharma) App For That

Data mining makes it possible not only to suggest new friends on your social media account and follow you around online shopping, but also to promote prescription drugs through doctor-only platforms. Big Pharma's modus operandi has long been drug rep visits, article reprints, and peer pressure, but more and more, manpower and paper are being exchanged for digitally automated marketing strategies.

Certainly, drug companies still rely on face time with drug reps to promote their products. But according to several news stories this year, digital marketing efforts are increasing. The November Vox article that quoted Dr. Fugh-Berman focused on three of Pharma's digital platforms: Electronic health records (which are replacing hospital paper records); physician social media sites (the Facebook or LinkedIn equivalents for health care providers); and phone apps (which provide on-the-go information about drugs and ailments).

These are ideal places for Pharma to advertise, and they're upping the ante on audience engagement. For example, hard-copy reprints of journal articles favoring a company's drug used to be Pharma's second-highest marketing expenditure. Last year, Medical Marketing & Media reported that reprints
 even electronic versions  are out of favor: "They have to find a way to make the content more engaging and interactive than a PDF," said Nicole Woodland-De Van, SVP of buying services and deliverables at Compas. According to Christopher Manz MD in The New England Journal of Medicine, physician social media site Sermo created games like "an 'Alzheimer's Challenge' that allowed physicians to read through clinical trial data (in a format similar to print journal advertisements) for a brand-name medication and answer questions about its indications to earn points redeemable for cash."

Electronic health records (EHRs) and phone apps also make data collection far easier for drug companies. "For decades, companies have been able to tell which drugs I prescribe but with EHRs they can tell when and why I prescribe," said Manz. And as Dr. Fugh-Berman told Vox, searches from Epocrates and other apps are also collected by Pharma for targeted marketing purposes.

Regulations have yet to catch up with pharmaceutical digital marketing practices, and it may be difficult to achieve. Consumers are so accustomed to custom-picked ads every time we use the Internet that it has become a normal, expected part of a streamlined online experience. PharmedOut has focused on exposing subtle marketing messages that evade regulations on drug rep visits and advertising. It doesn't get much more subtle than "targeted banner advertisements, e-coupons, or even curated drop-down menus" on digital tools for physicians.

News Round-Up 
(for more, please follow @pharmed_out on Twitter!)

November 1: The Telegraph: "Doctors refusing to prescribe statins"

November 3: HealthDay via WebMD: "Room to Improve in Typical ADHD Care: Study

November 4: WSJ Pharmalot: "Some Payments to Docs Don’t Have to be Reported to Sunshine Database"

November 9: The Daily Beast: "Mother’s Little Anti-Psychotic Is Worth $6.9 Billion A Year"

November 13: The New England Journal of Medicine: "High-Cost Generic Drugs — Implications for Patients and Policymakers"

November 13: Los Angeles Times: "Op-Ed: The sham drug idea of the year: 'pink Viagra'

November 13: Newsweek: "Big Pharma Plays Hide-the-Ball With Data"

November 13: WSJ Pharmalot: "How Lobbying for Rare Disease Research Influences Congress and NIH"

November 13: The New England Journal of Medicine: "Marketing to Physicians in a Digital World"

November 14: Bloomberg: "Top U.S. Drug Official to Push for More Inspectors in China"

November 18: The Week: "Over a million people each year get pointless surgery"

November 18: The Washington Post: "Does it really cost $2.6 billion to develop a new drug?"

November 19: Bloomberg: "Drug Trial Results Can’t Be Hidden Under Proposed Rules"

November 20: WSJ Pharmalot: "Prescription Drug Spending Will Reach $1.3 Trillion – That’s Trillion – By 2018"

November 21: Al Jazeera America: "The dirty motivation behind Gilead’s hepatitis C agreement"

November 21: The Nader Page: "Big Pharma—Crony Capitalism Out of Control"

November 21: WSJ Pharmalot: "Testosterone Drugs may – or may not – Cause Heart Risk: EMA"

November 23: The New York Times: "Debate Persists Over Diagnosing Mental Health Disorders, Long After ‘Sybil’"

November 23: The New York Times: "Private Oncologists Being Forced Out, Leaving Patients to Face Higher Bills"

November 24: The Wall Street Journal: "Surgical Tool Gets Strongest Warning

November 25: The New York Times: "Panel Rejects Sternest F.D.A. Warning for Steroid Shots"

November 25: BioClinica: "3 Reasons to Share Data from Unsuccessful Clinical Trials"

November 26: The New York Times: "The Problem With Prostate Screening"

November 26: Nature: "Publishing: The peer-review scam"

November 26: JAMA: "US Food and Drug Administration and Design of Drug Approval Studies"

November 27: The New York Times"Using Doctors With Troubled Pasts to Market a Painkiller"

November 27: The Washington Post: "Two former NFL players describe prescription drug practices"

November 30: The New York Times: "Naloxone, a Drug to Stop Heroin Deaths, Is More Costly, the Police Say"

Check These Out!

FDA's new Drug Trials Snapshot is a new resource that provides breakdowns of demographic subgroups participating in clinical trials, as well as differences found among them.

In 12 minutes, this New York Times "Retro Report" covers the rise of Prozac and "lifestyle" drugs, and industry's marketing of them.

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