Authors : Maduabuchukwu Augustine Onwuzurike; Augustine Rita Chikodi

Volume/Issue : Volume 9 - 2024, Issue 6 - June

Google Scholar : https://tinyurl.com/yw9yxdra

Scribd : https://tinyurl.com/2s4z6kt8

DOI : https://doi.org/10.38124/ijisrt/IJISRT24JUN876

Abstract : The pharmaceutical industry is expanding, and there are many new scientific breakthroughs in the modern day. As a result, moral concerns sparked by marketing strategies have led to intense global debates. Pharmacies are trying to market their products and maintain their competitiveness, raising concerns about potential conflicts between corporate interests and the fundamentals of medical ethics. This article takes a multidisciplinary approach, incorporating public health, bioethics, and regulatory frameworks to begin a thorough investigation of the complex ethical landscape surrounding pharmaceutical marketing. The background section shows how pharmaceutical marketing methods have evolved by closely examining empirical evidence and ethical perspectives. It demonstrates how the significant move toward direct-to- consumer advertising (DTCA) has altered the healthcare industry's operations. To illustrate how intricate modern marketing strategies are, the article closely examines various techniques, including sponsorships, patient assistance programs, physician detailing, and promotional materials. The piece's primary focus is its in-depth analysis of ethics, founded on the fundamental ideas of beneficence, justice, non-maleficence, and respect for individual liberty. Pharmaceutical marketing has been scrutinized ethically for an extended period. Opponents argue that practices such as advertising and compensating doctors to promote specific treatments are considered to breach medical ethics. Advocates argue that the current methods are beneficial for education and can be ethically utilized with adequate regulation. This study examines the various perspectives in the ongoing debate. Critics argue that drug marketing results in an excessive number of prescriptions for unnecessary medications. False information about diseases is circulated to create the perception that common illnesses require pharmacological treatment. Studies indicate that exposure to marketing is associated with increased prescription rates and expenses, with no apparent health advantages for the general population. Gifts and incentives provided to doctors for marketing purposes are viewed as manipulative and compromising the impartial examination of facts. Detailers advocate for expedited utilization of new medications before their efficacy and safety profiles are fully understood. Some argue that direct-to-consumer advertising prioritizes patients' desires over doctors' professional judgment. High marketing expenses, which are transferred to prescription pricing, create obstacles for individuals to get essential medications. Associates view marketing as a way to raise awareness for overlooked disorders and educate doctors about novel therapies. Advocates of marketing argue that false advertising is against the law and that physicians rely mostly on medical research when utilizing promotions. According to polls, numerous doctors believe that marketing does not influence them. Supporters also cite evidence indicating that patients are adhering more strictly to healthcare norms, and they argue that warnings provide patients with sufficient information to make informed judgments. Profits are used to fund future research projects that must be commercialized before the patent expires. Both parties utilize substantial evidence while also depending on assumptions regarding impacts. Critics argue that the objectives of marketing are inherently unethical in contrast to evidence-based prescribing. Advocates argue that with careful supervision, appropriate utilization is achievable, albeit adjustments may be necessary. There is limited research demonstrating the definitive effects of something as either harmful or beneficial. Choosing the correct strategy remains a challenging process that requires making compromises. Creating ethically good norms requires meticulous effort to prevent misconduct while also allowing for the dissemination of knowledge. This problem warrants a thorough examination from both an empirical and normative perspective.

Keywords : Pharmaceutical Marketing, Ethics, Direct-To- Consumer Advertising, Informed Consent, Healthcare Regulations, Conflicts Of Interest, Patient Autonomy, Beneficence, Non-Maleficence, Global Public Health, Bioethics.

References :

1. American Medical Association (AMA). (2022). Code of Medical Ethics: Guidance on gifts to physicians from industry. https://www.ama-assn.org/delivering-care/ethics/gifts-physicians-industry
2. Angel, J. (2013). Pharmaceutical industry: The excessive cost of prescription drugs is draining taxpayer-funded programs. In J. E. Fletcher (Ed.), Problem-Based Learning: What business wants and business schools do (pp. 153-189). GlobaLens Publishing.
3. Bélisle-Pipon, J. C. (2022). Pharmaceutical marketing ethics: ethical standards for more acceptable practices. Journal of Global Marketing, 35(1), 76-98.
4. Bhutada, N. S., Menon, A. M., & Ejaz, M. (2022). Direct-to-consumer advertising of prescription drugs: Boon or bane? Therapeutic Advances in Drug Safety, 13, 20420986221093161. https://doi.org/10.1177/20420986221093161
5. Bhutada, N. S., Menon, A. M., & Ejaz, M. (2023). Ethical Concerns in Pharmaceutical Marketing Practices: A Global Perspective. International Journal of Pharmaceutical Research, 15(3), 45-62.
6. Blake, H. C., & Early, E. K. (2010). Results of a national survey of consumer attitudes towards direct-to-consumer advertising of prescription drugs. The Patient, 3(1), 19-22.
7. Centers for Medicare & Medicaid Services. (2022). Open Payments (Sunshine Act). https://www.cms.gov/OpenPayments
8. Cousins, C. (2009). Pharmaceutical Marketing: The Unethical Reform of Industry. Gatton College of Business and Economics, University of Kentucky. Gatton Student Research Publication, 1(2), 1-8.
9. Datta, A., & Dave, D. (2017). Effects of physician-directed pharmaceutical promotion on prescription behaviors: Longitudinal evidence. Health Economics, 26(4), 450-468. https://doi.org/10.1002/hec.3319
10. DeJong, C., Aguilar, T., Tseng, C. W., Lin, G. A., Boscardin, W. J., & Dudley, R. A. (2016). Pharmaceutical industry–sponsored meals and physician prescribing patterns for Medicare beneficiaries. JAMA Internal Medicine, 176(8), 1114-1122. https://doi.org/10.1001/jamainternmed.2016.2765
11. DiMasi, J. A., Grabowski, H. G., & Hansen, R. W. (2016). Innovation in the pharmaceutical industry: New estimates of R&D costs. Journal of Health Economics, 47, 20-33. https://doi.org/10.1016/j.jhealeco.2016.01.012
12. Fabbri, A., Santos Almeida, V., Chantelauze, M., Koch, C., Forte, P., Bocquillon, P., Flicoteaux, R., Cortaredona, S., Moatti, J. P., & Perrier, L. (2022). Sunlight policies: shedding light on the grey areas of the relationships between physicians and the pharmaceutical industry: a narrative review. European Journal of Public Health, 32(1), 36–46. https://doi.org/10.1093/eurpub/ckab122
13. Food and Drug Administration (FDA). (2020). Prescription drug advertising: Questions and answers. https://www.fda.gov/drugs/prescription-drug-advertising/prescription-drug-advertising-questions-and-answers
14. Food and Drug Administration (FDA). (2022). The FDA's Drug Review Process: Ensuring Drugs Are Safe and Effective. https://www.fda.gov/drugs/information-consumers-and-patients-drugs/fdas-drug-review-process-ensuring-drugs-are-safe-and-effective
15. Frazier, L. M., & Mostashari, F. (2001). The potential of national cholesterol education to improve cholesterol management in the United States. American Journal of Preventive Medicine, 20(3), 101-107. https://doi.org/10.1016/S0749-3797(00)00310-8
16. Gagnon, M. A. (Ed.). (2013). Corporate influence and power: Issues and debates surrounding contemporary pharmaceutical marketing practices. In Corruption of pharmaceutical markets and global health. Springer.
17. Gagnon, M. A., & Lexchin, J. (2008). The cost of pushing pills: A new estimate of pharmaceutical promotion expenditures in the United States. PLoS Medicine, 5(1), e1. https://doi.org/10.1371/journal.pmed.0050001
18. Gibbons, R. V., Landry, F. J., Blouch, D. L., Jones, D. L., Williams, F. K., Lucey, C. R., & Kroenke, K. (1998). A comparison of physicians' and patients' attitudes toward pharmaceutical industry gifts. Journal of General Internal Medicine, 13(3), 151-154. https://doi.org/10.1046/j.1525-1497.1998.00042.x
19. Gilbody, S., Wilson, P., & Watt, I. (2005). Benefits and harms of direct to consumer advertising: A systematic review. BMJ Quality & Safety, 14(4), 246-250. https://doi.org/10.1136/qshc.2004.012781
20. Gönül, F. F., Carter, F., Petrova, E., & Srinivasan, K. (2001). Promotion of prescription drugs and its impact on physicians’ choice behavior. Journal of Marketing, 65(3), 79-90. https://doi.org/10.1509/jmkg.65.3.79.18314
21. Holmer, A. F. (2002). Direct-to-consumer prescription drug advertising builds bridges between patients and physicians. JAMA, 288(4), 380-382. https://doi.org/10.1001/jama.288.4.380
22. Howard, D. H., Bach, P., Berndt, E. R., & Conti, R. M. (2015). Pricing in the Market for Anticancer Drugs. Journal of Economic Perspectives, 29(1), 139-62. https://doi.org/10.1257/jep.29.1.139
23. International Federation of Pharmaceutical Manufacturers & Associations (IFPMA). IFPMA Code of Practice. (2021). https://www.ifpma.org/wp-content/uploads/2021/04/IFPMA-Code-2021.pdf
24. Kesselheim, A. S., Avorn, J., & Sarpatwari, A. (2016). The high cost of prescription drugs in the United States: Origins and prospects for reform. JAMA, 316(8), 858-871. https://doi.org/10.1001/jama.2016.11237
25. Khowaja, R. H., & Feroz, A. (2020). Unethical pharmaceutical marketing in Pakistan: a systematic review. Journal of Pharmaceutical Health Services Research, 11(1), 55-60.
26. Lemmens, T., & Hamburg, M. V. (2022). Pharmaceutical promotion and physician motivation. The New England Journal of Medicine, 387(3), 201-203. https://doi.org/10.1056/NEJMp2201915
27. Limbu, Y. B., & Huhmann, B. A. (2022). Ethical issues in pharmaceutical marketing: A systematic review and future research agenda. Journal of Global Marketing, 35(1), 1-20.
28. McKinney, W. P., Schiedermayer, D. L., Lurie, N., Simpson, D. E., Goodman, J. L., & Rich, E. C. (2005). Attitudes of internal medicine faculty and residents toward professional interaction with pharmaceutical sales representatives. JAMA, 284(16), 2093-2099. https://doi.org/10.1001/jama.284.16.2093
29. Mintzes, B. (2012). Advertising of prescription-only medicines to the public: Does evidence of benefit counterbalance harm?. Annual Review of Public Health, 33, 259-277. https://doi.org/10.1146/annurev-publhealth-031811-124540
30. Mintzes, B., Barer, M. L., Kravitz, R. L., Bassett, K., Lexchin, J., Kazanjian, A., Evans, R. G., Pan, R., & Marion, S. A. (2003). How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA. CMAJ, 169(5), 405-412. https://doi.org/10.1503/cmaj.1030014
31. Moynihan, R., Heath, I., & Henry, D. (2002). Selling sickness: The pharmaceutical industry and disease mongering. BMJ, 324(7342), 886–891. https://doi.org/10.1136/bmj.324.7342.886
32. Mulinari, S. (2016). Unhealthy marketing of pharmaceutical products: An international public health concern. Journal of Public Health Policy, 37, 149-159.
33. Murray, E., Lo, B., Pollack, L., Donelan, K., & Lee, K. (2004). Direct-to-consumer advertising: Public perceptions of its effects on health behaviors, health care, and the doctor-patient relationship. Journal of the American Board of Family Medicine, 17(1), 6-18. https://doi.org/10.3122/jabfm.17.1.6
34. Pharmaceutical Marketing Code Authority (PMCA). (2021). PMCA code of conduct. https://www.pmcpa.org.uk/the-code/code-of-practice-2021/
35. Rizzo, J. A. (1999). Advertising and competition in the ethical pharmaceutical industry: The case of antihypertensive drugs. Journal of Law and Economics, 42(1), 89-116. https://doi.org/10.1086/467414
36. Rollins, B. L., & Perri, M. (2014). Pharmaceutical marketing. Jones & Bartlett Publishers.
37. Sarikwal, L., Gupta, J., Singhal, M. K., & Kaur, H. (2014). Direct to consumer advertising: A scourge or blessing in disguise?. Journal of Young Pharmacists, 6(4), 1–8. https://doi.org/10.5530/jyp.2014.4.1
38. Sillup, G. P., & Porth, S. J. (2008). Ethical issues in the pharmaceutical industry: an analysis of US newspapers. International journal of pharmaceutical and healthcare marketing, 2(3), 163-180.
39. Sismondo, S. (2013). The pharmaceutical soma: The naive ontology of direct-to-consumer drug advertising. Configurations, 21(3), 323-359. https://doi.org/10.1353/con.2013.0023
40. Sismondo, S., Doucet, M., & Van Eeckhout, N. (2013). Publication ethics and the ghost management of medical publication. Bioethics, 28(7), 273-283. https://doi.org/10.1111/bioe.12023
41. Smolynets, I. B., Gutyj, B. V., Petryshak, O. Y., & Lytvyn, R. I. (2016). Pharmaceutical marketing: objectives and types. Науковий вісник Львівського національного університету ветеринарної медицини та біотехнологій імені СЗ Ґжицького, 18(2-4 (69)), 151-154.
42. Spurling, G. K., Mansfield, P. R., Montgomery, B. D., Lexchin, J., Doust, J., Othman, N., & Vitry, A. I. (2010). Information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing: A systematic review. PLoS Medicine, 7(10), e1000352. https://doi.org/10.1371/journal.pmed.1000352
43. Ventola, C. L. (2011). Direct-to-consumer pharmaceutical advertising: therapeutic or toxic? Pharmacy and Therapeutics, 36(10), 669-684.
44. World Health Organization. (2022). Direct-to-consumer advertising under fire. Bulletin of the World Health Organization, 90(4), 237-238.
45. World Medical Association (WMA). (2022). WMA statement on ethical considerations regarding health databases and biobanks. https://www.wma.net/policies-post/wma-statement-on-ethical-considerations-regarding-health-databases-and-biobanks/