PETER ROST: PHARMA MARKETING EXPERT WITNESS. AWP, MEDICAL DEVICE EXPERT.: The Internet and Drug Advertising
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PETER ROST: PHARMA MARKETING EXPERT WITNESS. AWP, MEDICAL DEVICE EXPERT.

Peter Rost, M.D., is a former Pfizer Marketing Vice President providing services as a medical device and drug expert witness and pharmaceutical marketing expert. Judge Sanders: "The court agrees with defendants' view that Dr. Rost is a very adept and seasoned expert witness." He is also the author of Emergency Surgery, The Whistleblower and Killer Drug. You can reach him on rostpeter (insert symbol) hotmail.com. Please read the terms of use agreement and privacy policy for this blog carefully.

The Internet and Drug Advertising

Big Pharma spends a lot on Internet ads, a whopping $13.8 billion in the first quarter this year.

Is it worth is? After all, doctors write the prescriptions, so why advertise to regular people?

You bet it's worth it!

According to a study by MRx Health/Informed Medical Communications, doctors grant 87% of patient requests for specific drugs.

But it doesn't stop there. Many of those patients asking for a specific drug read about it on . . . the Internet.

Here are the numbers.

Percent of consumers who ask their doctors for specific drugs based on:

What they read on the Internet--34%
What family and friends say--33%
What they see on television--31%
What they read in the newspaper--3%

Did you notice that last number? 3%!

Now you know why the Internet and evening television is booming with drug commercials, showing happy, dancing people, and why regular newspapers are in trouble.

24 Comments:

Blogger antichrist said...

And this could be the real reason you were targeted by the HuffPost troll, eventually leading to you being canned. HuffPost would want a part of that $13.8 billion in ad venue. They knew that big pharma could not advertise on HoffPost with you there debunking them. Pharma ads would become a catalyst for anti-pharma discussion, and no corporation wants that.

6/27/2006  
Blogger MsMelody said...

I always wondered why my anti-pharmaceutical "comments" were either never posted, or were posted only after the blog was scrolled off the main page. There was always a niggling suspicion (and I posted comments to this effect, too), that someone at HuffPo either had a vested interest in one or more pharmaceutical companies--or were just pro-corporation/anti-citizen, in general.

Here's my promo:
http://www.tooprofitableto cure.com

and here's a question/suggestion:

Why don't you have an article where we readers could share our thoughts on "most ridiculous Rx ad on television." Of course, that might be too instructive to PharmaAdvertising, and they would work diligently, using input by "we commoners" to redirect their focus. I certainly don't want to provide the ammunition with which they can shoot us.

6/27/2006  
Blogger Roger Rancourt said...

Still to this day, big pharma is pulling its scams on the blogosphere.

Marketing personafied.....Huffington Post was just another leg in the plan.

That is the real reason trolls like Jonah are allowed to run the show, they make the big bucks.

6/27/2006  
Anonymous Anonymous said...

Welcome back to subject matter you excel at Doc. Although, uncovering the rather unusual goings on behind the scene at THP was an enlightening intrigue for a couple days. Interesting coincidence (timing wise) with your discovery of Whacko-Yaco comment activity, ID, and JWT week at THP?

Personally, I rather enjoy a good intrigue, and even the occassional simple diversion (a la baby bird).

Link to a good article originally published by the Guardian/UK. It provides a little more international prespective on ethics (or lack there of), marketing tactics, and spending - http://www.commondreams.org/headlines06/0626-02.htm

Money quote: "Consumers should be concerned because time and again the companies violate their own industry's ethical marketing codes."

6/27/2006  
Anonymous thebronxzoo said...

The whole mess is grossly compounded by the cozy relationship between the pharmaceutical companies and the FDA. Additionally, the bulk of medical research going on at the university level is now paid for by drug company money and not public grants.

Please read the following article that appeared in the Washington Post today:
http://www.washingtonpost.com/wp-dyn/content/article/2006/06/26/AR2006062601125.html

6/27/2006  
Anonymous Anonymous said...

Finally, something other than THP. This is why I read your stuff.

One has to wonder whether "ethical marketing" is as much an oxymoron as "military intelligence" or "common sense".

Not included in all those advertising dollars are the twin beasts of spamming and comment hacking, which seems to be where the pharma industry spends a lot of off budget money (through wholesalers and distributers rather than drug companies themselves).

It also feeds the need for an entire industry devoted to spam-blocking email.

Print is dying and I say Good Riddance. Newspapers and magazines are environmentally unsustainable. So is the Internet but that's another post.

6/27/2006  
Anonymous Rosethejet said...

Fascinating, and the link between big Phrama and Arianna is pretty much undeniable now.

Get rid of the person who exposes the frauds the pharma industry perpetrates upon the world and you make that much more money.

What is really a shame is that Arianna has sold her soul to very same people who control the government while at the very same time pretending to lash out at them.

All the while of course pocketing their money.

Arianna has lost all credibility and for the same reason our congress and big business have.


Money.

The love of money is indeed at the root of all evil.

6/27/2006  
Blogger MsMelody said...

to: thebronxzoo

Thanks for the heads up WP article. Did you notice that the largest decline in warnings letters was to device makers? If you're a diabetic--and use a glucose monitor--it might be of interest to know that the FDA allows a +/- 20 margin or error, although they don't state it exactly in that manner. When you consider that this margin of error is allowed on both ends of the testing spectrum, you can appreciate that diabetics are at risk not only from dangerous new rDNA insulins and analogs--but from the very equipment that is supposed to AID them in their quest for "normalcy."

6/27/2006  
Blogger Physics Goddess said...

Very interesting numbers, those.

Of course, newspapers face a variety of challenges in the internet era; decreasing ad revenue from decreasing readership is just one of them.

I've found the increased marketing of particular drugs over the past decade or so to be a fascinating, if somewhat inevitable, turn of events. I realize that there are illnesses that remain dangerously undiagnosed and that more attention should be brought to them; but should this increased awareness be marketed to the "supply" side (doctors) or the "demand" side (patients)? I can see where both have their advantages and disadvantages.

Another aspect of this phenonmenon that fascinates me is mentioned by the study quoted: "doctors grant 87% of patient requests for specific drugs." This at least partly opens a pandora's box of issues in my mind: whether or not the patients really need the medications they're requesting, how often doctors carefully diagnose the patient if they request a medication, etc.

I realize it's a great marketing strategy, and is obviously very successful; but I worry somewhat about its long term implications.

6/27/2006  
Anonymous Jeff Z said...

This survey is not completely useless, but the methodology cited in the sidebar of the original article make it clear that its applicability is wildly overstated. Most obviously:

1) Respondents were triply self-selected: First as regular internet users, then as members of an online survey database, and finally as those members who agreed to take the survey. In other words, this survey is of people who are heavy internet-users, active survey-takers, and very interested in pharmaceuticals. Not an insignificant market, but a niche market all the same.

2) Your statement “Doctors grant 87% of patient requests for specific drugs” is misleading for several reasons:

A) By the previously referred to self-selection process, these people are very well-educated about pharmaceuticals, at least as compared to the general population, and will go into see their doctors already quite well-informed. This is especially important because patients with chronic illnesses often develop quite a bit of expertise.

B) We have no idea as to what the drugs in question are or what the request is. Is the patient asking for a generic or resisting it? Are they saying they are willing to tolerate the sting of Finacea for an off-label treatment rather than the approved, but less-effective treatment? Are they disagreeing with their doctor or would the doctor have chosen that drug anyway? Is it a useless drug that the patient was suckered into asking for by advertising? And so forth.

C) The “87%” does not mean 87% of all respondents, but only the respondents who asked for a specific drug. At this point it is difficult to extrapolate, because I could not find the raw numerical data (time crunch), but according to the subhead on p.54 of the original article: which reads: “62% spoke to their doctor about information they found online; 34% of those asked for a specific Rx.” So let’s work the numbers: .62% * 34% = 21% * 87% = 18.3%. 18.3% is the actual number of—self-selected—survey respondents who asked for and received a specific drug.

D) There is no specific question asking them to elaborate on how often they ask for a specific drug and if they ever asked for a drug and were not given it.

3) According to your lead, 1st Quarter 2006 pharma internet ad spend was $13.6 billion, an astonishing amount for an industry whose average total quarterly global revenues in 2005 were $150.5 billion. http://www.imshealth.com/ims/portal/front/articleC/0,2777,6599_77478579_77478598,00.html

Furthermore, the most recent free trustworthy internet advertising revenue report I could find was PriceWaterhouseCooper’s April, 2005, survey of inernet ad revenue, sponsored by the IAB (Interactive Advertising Bureau). The most recent quarter surveyed was 4th Quarter 2004, which reported total ad spend from all sources as $2.69 billion, of which 6%, or $161.4 million came from a category identified as “Pharmaceutical & Healthcare.” http://www.iab.net/resources/adrevenue/pdf/IAB_PwC_2004full.pdf
In 15 months, then, according to you, quarterly pharmaceutical internet advertising has gone from $161.4 million to $13.8 billion.

4) Finally, regular newspapers are not in trouble because companies do not advertise in them; rather, companies do not advertise in the newspapers because they are in trouble.

6/27/2006  
Blogger Roger Rancourt said...

Psychic Goddess, you remember your past lives?

Wow, so does my brother. We thought that was some rare thing...

And has anyone seen this?

http://www.creativecircle.co.uk/2006/bronzehonours.htm

Money is indeed a root of all evil at least the love of fake money, which is what the neocons do.

JWT does the marketing for the whole progressive blogopshere, and they represent....Surprise! Pfizer Viagra, Pfizer Sudafed, Pfizer "excedrin", Pfizer Calprofen, Xalatan, the list goes down the line....

I realize its important to debate the Israel lobby and solve this crisis...but it is equally important, to debate the effect drugs have had on our society.

I'm not talking about natural medicine, because thats a totally different and safe industry.

I am talking about Big Pharmaceutical and Bill Frist, and now it has leaked EVERYWHERE, you can not go any place and not hear Pfizer mentioned!!

Not even on the blogs anymore!! And you see it, because Rush Limbaugh just got arrested again.

CAUGHT with illegal drugs!!! And these drugs are poisonous, yet the neocons made them and make trillions off them.

6/27/2006  
Blogger beeta said...

jeff z,
Your points are totally valid. But It is undeniable that Pharma spends a ton of money on ads everywhere and I don't need a survey to believe it. Why else I could recite the name of at least 10 drugs I hope I never need. Repeated exposure!
I think the root problem is that the Medical community in general isn't trying to find causes of most common ailments (I don't mean cancer, AIDS, or comon infections)because the root causes are our way of life, foods we eat, social pressures, lack of physical activity etc. To eradicate the root causes we have to reconsider the whole political/social structure of our society. So the easiest way is to develop drugs to treat the symptoms, but every drug has side effects that in turn have to be treated with drugs..... and on and on. ...... AND a whole bunch of people make a whole bunch of money in the process.
BTW the war on drugs is closely related to this. Unregulated markets with high profit levels cuts into Pharma profits... better to charge people high prices and sell them legal mood altering meds than letting them do it with cheaper(if it was not illigal) more natural forms.

6/27/2006  
Anonymous Jeff Z said...

Beeta: Pharmaceutical companies certainly do spend a fortune on advertising and undoubtedly the effects are at times pernicious (getting people to use drugs they otherwise would not), but also beneficial (learning about drugs or their uses that were otherwise unknown) or simply non-existent as well. There would have to be a very careful study done to see what influence actually occurs that otherwise would not have. I lack both the time and resources to search for any that may have been done.

In my own experience, which is simply anecdotal, drug choices are far more strongly influenced by one’s medical insurance coverage—i.e. what tier a drug is in—than by advertising.

You are absolutely right that for most people in developed societies, their day-to-day habits will do far more to determine their health than anything else.

Many people have suffered from the “drugs to treat the drugs” phenomenon you describe, but vastly more have had their lives saved by them, including me, several times.

Various experiments apropos of your proposal to “reconsider the political/social structure of our society” were extensively performed throughout the 20th century. Results demonstrated that even those who survived had poorer health than the control groups.

Also, pharmaceuticals would not be able to compete cost-effectively in commodity markets like heroin, cocaine, etc., so I do not think your drug war theory is accurate.

Now, Budweiser, on the other hand….

6/27/2006  
Anonymous bebop said...

I have a free trial subscription to Time magazine and I can tell you that I'm basically getting a newsletter telling me all the unnecessary drugs out there for me to consume.

6/27/2006  
Anonymous thebronxzoo said...

msmelody

Yes, there's the least supervision of medical devices which is rather horrific if you realize the small tolerances in function that are typically allowed for a person to be healthy.

Consumer groups can't possibly compete with the lobbying power of the big pharmaceutical companies in Washington. What I particularly hate is the way the pharmaceutical companies have all but taken over medical research, particularly in my field which is psychiatry.

6/27/2006  
Blogger beeta said...

Jeff z,
Again I mostly agree with you.
I am not suggesting that all meds are bad or that there isn't any benefit from medical resaerch.
If a miracle cure for cancer were to be found tomorrow anyone with cancer would try it and any decent Dr. would prescribe it and there won't be any reason to advertise it as such (and the way patents are set up, one company would have the monopoly). And if there were side effects from it , it still would be better than the alternative of dying.
The bulk of the ads are however, not about drugs that save lives or even cure anything. There are about drugs that mask symptoms of causes that are related to food, environment,social pressures or prolonging youth (or whatever the perfect word for describing the obssession with youth is).
My reference to war on drugs was not to advocate a drug crazed free for all. I meant that the organized monopolistic Pharma industry opposes any natural drug/supplement/etc. from being sold over their synthetic/overpriced/dangerous products. Most advertised products are either for pain or depression and anxiety or for digestive problems that can be managed by natural/cheaper/safer products.

6/27/2006  
Blogger beeta said...

bebop,
Quick! Burn the whole stack of them before they sucker you in!

6/27/2006  
Blogger beeta said...

BTW on the lighter side:
Who has the title of "Medicated First Lady"?

6/27/2006  
Blogger MsMelody said...

thebronxzoo:

Here are a couple of graphs from my husband's book that illuminate the how and why of Big Pharma's takeover of "scientific research."

The AMA, in its infinite wisdom, determined that if doctors wished to maintain their godlike prestige and associated income, the supply of doctors should be limited. In the 20th century (1900-1999), the population of the United States increased over 300%. In the same timeframe, medical schools declined by 25%. Depending on which medical school you target, over 60% of all applicants are rejected. The rejections are not due to lack of intelligence or ability; the rejections are to allow the AMA to maintain the status quo—to maintain the income level and prestige associated with the profession. By restricting the pool of medical practitioners, the AMA has simplified the pharmaceutical corporations’ task of corrupting this small but elite group. In essence, it suits the pharmaceutical corporations perfectly for medical schools to produce a small, captive audience. How much easier is it for the pharmaceutical corporations to train these well-educated, privileged few to become legal drug pushers than it is for the drug cartel dons to initiate the illegal drug pusher?

To clarify these facts, consider that doctors at major teaching and research institutions have formed very lucrative deals to supplement their taxpayer-financed salaries. Among such deals are payments for administering research grants; consulting contracts; royalties for patents developed using taxpayers’ dollars; hefty speaking honoraria; fees for peer-reviewing journal articles; and expense-paid, industry-sponsored seminars and symposia. Not all doctors receive such perks, but the message for all is clear: Play ball with the pharmaceutical corporations; the pockets you line will be your own.

6/27/2006  
Anonymous thebronxzoo said...

msmelody

I completely agree with you and I'm a doctor. It gets so insidious that the drug reps actually have statistics on the prescriptions that docs in their area prescribe. If you prescribe a lot of a company's newest drug, you get perks. I absolutely hate it and don't think it should be that way but I've seen countless collegues grasp at that tit.

6/27/2006  
Anonymous bebop said...

Drug companies aren't in the business of curing anything. They are in the business of providing remedies. If they cured all the illnesses, what would happen to their business? They can't cure atheletes foot and the common cold after how many years of trying and they're talking about curing Cancer and AIDS? Riiiiight. It's all about the money. Magic looks healthier than 99% of non-HIV positive people.

6/27/2006  
Anonymous thebronxzoo said...

bebop

I won't argue with you about the remedy thing vs cure. The fact is that the science is beginning to be there to actually cure and that's what's so tragic. I can just tel you as someone who operates within the system to try to help people it's really frustrating and sad.

6/27/2006  
Blogger John Mack said...

Are you sure of your numbers? As soon as I saw $13.8 Billion spend by pharma on INternet Ads in Q106, I stopped reading your blog.

This number is way off -- by a factor of one thousand I would imagine. The ENTIRE amount of Internet advertising by ALL advertisers is no where near $55 BILLION per year ($13.8 x4). The entire promotional budget for the pharma industry (705 of which is aimed at doctors and includes the inflated value of samples given to docs) is $20 Billion or so. Only about 5% or less of that ($20 million per year or $4 Million per quarter) is spent on Internet promotions of all kinds.

So, I am curious where you got your number from?

John Mack
Pharma Marketing Blog
http://www.pharmamarketingblog.com

6/28/2006  
Anonymous Anonymous said...

To John Mack-

Is your total budget estimate of $20B for US spending alone, or is this a global spending number?

6/28/2006  

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