Last night’s Four Corners exposé of Big Vitamins marketing their supplementary pills via community pharmacists would have had doctors throughout the nation nodding their heads.
We only have to walk past a pharmacy shopfront to see how rife the problem is. Clearly most pharmacist-owners see it as a profitable—some would argue, a critical—part of their business plan.
As for pharmacist-employees, most are presumably resigned to selling these supplements by the kilo, and some would perhaps believe the industry’s own hype that ‘pick me up’ vitamins really do pick people up. Even well people, with clean livers.
The issue is not so much the selling of products in a free market, but the dubious veneer of scientific credibility, beginning with exaggerated or false advertising claims and ending with a highly trained, trusted professional. As a pharmacist said on the show, “If they’re after complementary medicines, then I’m happy to provide them”.
After such media reports featuring sceptical doctors, inevitably some commenters retort by questioning why they pick on pharmacists, when the medical profession itself is so influenced by Big Pharma. Something about sinners casting the first stone.
And, you know what? They have a point. So, let’s lob a few stones in every direction, even if a wall of my own glass house cracks.
Take the Four Corners quote about how promotional budgets inevitably trump research budgets: “You get a much more profitable return on investment from putting fifty million dollars into celebrity marketing.”
This is unarguably true if you’re selling vitamins, but a parallel model operates in medicine. Who is the equivalent of a celebrity in the doctors’ world? The medical expert.
A few days before the Four Corners report, another, less vaunted, ABC News story ran about the marketing of new blood-thinning medicines.
Thanks to the obligatory reporting of total Australian pharmaceutical budgets spent on doctors back in 2015 (an obligation since scrapped), the ABC revealed that in just six months, $2.6 million was spent on doctors to market the new anticoagulants.
The “celebrities” in this case were haematologists and other medical specialists who were judged to be what pharma calls “key opinion leaders”. Some $185,000 was spent flying 25 of them to Vienna, and $86,000 paid for six to go to Canada.
They came back home to run sponsored journal clubs in hospitals, speak to thousands of GPs at dinners, and give interviews to the media to promote how ‘old hat’ it is for GPs to prescribe plain old warfarin.
As with selling vitamins, the celebrity endorsement played its part in a huge upsurge of sales.
The new anticoagulants jumped right to the top tiers of PBS spending and will sit there until the excitement wears off, the patent wears off, non-sponsored research catches up, and it’s time for the celebrities to move on to the next big thing.
So, I don’t see it as a question as to whether pharmacists or doctors should claim ‘casting’ rights on the first stone. Both professions should be encouraged to critique the influences of marketing.
This post was first published in Medical Observer, Feb 2017