Inverse Benefits Due To Drug Marketing Undermine Patient Safety And Public Health
Posted Jan 16 2011 2:41pm
Drugs that pharmaceutical companies market most aggressively to physicians and patients tend to offer less benefit and more harm to most patients — a phenomenon described as the “inverse benefit law” in a paper from the University of Texas Medical Branch at Galveston. Published online Thursday, Jan. 13 in the American Journal of Public Health, the article explores recent withdrawals of blockbuster drugs due to safety concerns and finds a clear pattern of physician-focused marketing tactics that ultimately exposed patients to a worsening benefit-to-harm ratio. Potential patient safety and public health implications include unnecessary exposure to adverse side effects, high medical costs and competition for scarce resources.
“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 co-author 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, coined by the authors and inspired by Hart’s inverse care law (1), is manifested in marketing techniques commonly deployed to extend a drug’s use beyond the proper evidence base. Brody and co-author Donald W. Light, a professor at the University of Medicine and Dentistry of New Jersey, identify these strategies and illustrate the “law” with recent examples:
Drugs that pharmaceutical companies market most aggressively to physicians and patients tend to offer less benefit and more harm to most patients — a phenomenon described as the “inverse benefit law” in a paper from the University of Texas Medical Branch at Galveston. Published online Thursday, Jan. 13 in the American Journal of Public Health, the article explores recent withdrawals of blockbuster drugs due to safety concerns and finds a clear pattern of physician-focused marketing tactics that ultimately exposed patients to a worsening benefit-to-harm ratio. Potential patient safety and public health implications include unnecessary exposure to adverse side effects, high medical costs and competition for scarce resources.
“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 co-author 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, coined by the authors and inspired by Hart’s inverse care law (1), is manifested in marketing techniques commonly deployed to extend a drug’s use beyond the proper evidence base. Brody and co-author Donald W. Light, a professor at the University of Medicine and Dentistry of New Jersey, identify these strategies and illustrate the “law” with recent examples: