How Big Pharma Is Fooling You -- and Your Doctor -- with Junk Science

By Niko Karvounis, Health Beat. Posted August 11, 2008.

This article originally appeared on Health Beat.

It's no secret that the pharmaceutical industry trades in junk science. Prescription drug companies distort research, fudge measures of drug effectiveness and generally control our knowledge of what works in medication. Big Pharma's track record of shady science is a serious problem, especially considering the fact that recent discussions about creating a Comparative-Effectiveness Research Institute currently hold a place for prescription drug companies on the organization's board.

The obvious problem is that, to the pharmaceutical industry, "research" is just a code-word for "smart-sounding marketing." If you really want a sense of how deep this deception runs, consider the fact that the prescription drug industry relies on so-called "research" not just to shill its drugs, but also to argue that it has a vital role to play in shaping the doctor-patient relationship for the better.

This dubious claim comes in the June 2008 issue of PharmaVoice where Meaghan Onofrey from CommonHealth, a pharma marketing consulting firm, pens a piece arguing that coaching from the prescription drug industry can make sure that "physicians and patients speak the same language" so that "everyone wins." According to Onofrey, "one case study illustrates [how marketers can help physicians improve their communication]: by videotaping primary-care physicians, who were struggling to assess migraine prevention candidacy with their migraine patients." According to Onofrey, it turned out that the doctors were actually asking the wrong questions of their patients. In working with key opinion leaders and advocacy groups, a simple solution was formulated to address the issue. These same physicians were taught to ask a single question to help them more simply and clearly identify the patients' candidacy for migraine prevention."

You might be wondering what this oh-so-effective single question is -- and so am I. Even GlaxoSmithKline's online "headache quiz," which users can take to see if they might have migraines (and thus might be a good target for prescription drugs) asks eight separate questions of patients. When it comes to migraines, it's tough to imagine a silver bullet question.

Yet Onofrey provides no specifics about the "study," leaving the reader with a load of unanswered questions. Under what conditions was the study executed? What were the patient profiles? What was the patient-physician dialogue specifically like before and after the "single question" solution? All we get is some PR spin concluding that it's important to better identify "prevention candidates" (a.k.a. potential customers) through "leveraging ... dialogues."

CommonHealth's research is paradigmatic of pharmaceutical industry science: talk a big game, but ensure that there's enough ambiguity so that the really meaningful results are hidden. This is exactly what we get in direct-to-consumer (DTC) advertising. Ads for Pfizer's Lipitor, for example, claim that the drug reduces the risk of heart attacks by 36 percent because studies show that two patients out of every hundred on the drug get heart attacks, versus three out of every hundred on placebos (which is a difference of one patient, or about one-third of the heart attacks that would have happened without Lipitor). This data obscure the fact that the drug only helps one out of every one hundred people who take it.

But there's something particularly bald-faced about claiming that marketers can feed doctors a script for the benefit of all involved. As John Mack, publisher of the Pharma Marketing Newsletter, points out on his blog, "Although the research is billed as a way that pharmaceutical companies can help improve physician-patient communications by helping physicians and patients 'speak the same language,' it obviously may be more useful to CommonHealth's pharma clients, who can 'demonstrate value to physicians beyond just the benefit of the brand, potentially creating an unexpected, yet mutually beneficial relationship.' i.e., sell more drugs.

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Niko Karvounis is a Program Officer with The Century Foundation in New York City, where he works on issues of socioeconomic inequality and health care. He is a regular contributor to Health Beat, the Foundation's health care blog.

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