Experts at University of Texas Medical Branch at Galveston are saying that drugs that are marketed aggressively by pharmaceutical companies offer less benefit and more harm to most patients.
The phenomenon described as the "inverse benefit law" undermines patient safety and public health, they said.
Advertisement"This is not a random occurrence, but rather a repeating, planned scenario in which drugs, discovered with good science for a specific set of patients, are marketed to a larger population as necessary, beneficial and safer than other alternatives," said Dr. Howard Brody, a professor and director of the Institute for the Medical Humanities at UTMB Health.
"Marketers are just doing their jobs. However, the reality is that for most new drugs, safety and efficacy are scientifically proven for only a small subset of patients. It's time for physicians to take a stand and not prescribe them so readily."
The inverse benefit law is manifested in marketing techniques commonly deployed to extend a drug's use beyond the proper evidence base.
For example, 'disease mongering' - Osteopenia, once considered a non-disease state in patients who had not lost enough bone density to be diagnosed with osteoporosis, has now turned into a disease itself, tryin gto convince physicians and patients that biphosphonate drug treatment will prevent their 'disease' from progressing.
"While we looked only at marketing directed toward physicians, direct-to-consumer advertising plays a critical role in driving demand for a drug by patients who fall outside the group that might truly need it, and pressuring physicians to prescribe it more readily," said Brody.
Brody and Light recommend some actions: restrict writing usage guidelines to groups free of commercial conflicts of interest; independently fund and design trials focused on safety and efficacy; and create a neutral agency (e.g., a branch of the National Institutes for Health) to conduct drug trials, including comparative effectiveness research to improve evidence-based prescribing.
"There is an unintended, but direct conflict between pharmaceutical marketing and public health," said Brody.
"Physicians should approach commercial marketing by pharmaceutical companies with a critical eye. Future reform polices should look to reduce, minimize and limit these practices. Patients can also play an important role by being more skeptical of drug ads ... and remember, the most important directive in them is to 'talk to your doctor'."
The article appears in the American Journal of Public Health.
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