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how your doctors choose your medications


Harris Polls have been around since the early 1960’s.  Although not quite as famous as the Gallup Polls, Harris Interactive (a publicly traded corporation) is nonetheless well-known in the world of online polling.  Unlike Gallup, they are strictly a market-based research entity, designed to collect information that helps companies figure out how to better sell their products.  Recently, The Harris Poll Physician Pulse Study quizzed practicing doctors concerning their prescribing habits by using something they call the “Trust Index“.   The Trust Index measures the five key components of the doctor-patient relationship, and is said to be, “highly predictive” of physician’s prescription habits and intent.  What did the study (released in January of this year) have to say about the relationship between Physician Trust and prescription habits?

Trust Drives Business.  The reason for the study’s focus on trust is that brands associated with high levels of trust are more likely to be endorsed, recommended, and prescribed by physicians. And when it comes to driving trust, emotional connection, relationships with sales representatives, and perceptions of the pharmaceutical company or companies backing the product can be just as influential factors as the attributes of the product itself.

Trust drives business is a truism.  Everyone who has ever been in business for themselves realizes this in a hurry —– or else they end up in bankruptcy court.  When it comes to the Pharmaceutical Industry, we would have to assume that this trust is built on a solid foundation.  In fact, I think that most of us would assume that our “trust” in certain drugs would be largely based on things like effectiveness, safety, research, past success, etc.  This would certainly be true in a perfect world.    Unfortunately, if you have been following my blog for very long, you may realize better than most how untrue this really is most of the time (HERE).  It’s like Andre Aggasi used to say as he touted Cannon cameras, “Image is everything“.  Joe Vorrasi, the Senior Vice President of Healthcare Research for Harris Interactive (The Harris Poll), quantified this idea by telling us just how important image is in selling pharmaceuticals.

“Our research clearly demonstrates that trust is about much more than efficacy alone. The importance of the emotional component is further borne out by the consistency with which the study’s trust leaders are shown to distinguish themselves on emotional measures in addition to functional ones.”

There you have it folks.  From the very words of the Harris Poll, it would seem that the most important factor for building trust is emotion.  And if you do not think that Wall Street’s advertising companies do not know how to elicit emotional responses with their ads, you are kidding yourself.   For Pete’s sake, there are people who watch the Super Bowl just for the ads!

The “trust-us” advertising flyers that the drug reps put in physician’s hands on a daily basis are geared toward creating an emotional response.  And the drug reps themselves?  They’re not flunkies.  They are salespeople who have received extensive training in the art of marketing, selling, and SCHMOOZING.  Although you may not like hearing how your doctor chose the drugs he / she prescribed you, just realize that it probably had nothing to do with any research they did for themselves.  There is simply not enough hours in the day — and way to many drugs to even try to keep up with it all.  So doctors trust the flyers and the drug reps.  And you trust your doctors.   And it’s all reinforced by the commercials you see on TV and read in Woman’s Day or AARP.  It kind of reminds me of a study that I saw about 20 years ago that I refer to as the Dove Soap Study.

The study itself had nothing whatsoever to do with Dove Soap, but if you have ever seen a bar of Dove, it is advertised as being 99 44/100 pure.  The research I saw said that once a doctor graduates from medical school, about 99.44% of what they learn about drugs for the rest of their careers comes as the direct result of what they were given or told by a drug rep.  Although the internet has, by its very nature, lowered this number, the current research still tells us that doctors are choosing your drugs based mostly on emotion.  This all begs the question of whether or not we can we trust Big Pharma?  Suuuuuuurrrrre we can.  We can trust them to lie, cheat, and work the system to their advantage (see first link in post).  How big is this problem here in America?

Just one short month ago, JAMA (Journal of the American Medical Association) felt it necessary to publish an article called Restoring Confidence in the Pharmaceutical Industry.  The stated purpose of the article was, “to help restore credibility and trust in their sponsored research“.  Why would the Medical Community feel a need to come to the rescue of Big Pharma?  Think about it for a moment.  Take away the drugs, and what does the medical community have to offer you?  Surgery?   Yay.   Dietary Recommendations?  I DON’T THINK SO.   Scary isn’t it?

Listen up folks; with billions of dollars at stake for each and every major player in the Pharmaceutical Industry, there is not a prayer in the world you are going to see this situation improve.  I have shown you repeatedly that blatant lying, misrepresenting research, and conflict-of-interest are now the norm.  And the multi-billion dollar fines now being handed out because of this behavior?  They are simply the price of doing business.  Here are a few excerpts, cherry-picked from the JAMA article.

Lack of trust in the pharmaceutical industry threatens the future of biomedical research….  We have had discussions with leaders of the pharmaceutical industry about concerns they have regarding the erosion of trust in their companies. We also have had discussions with academic leaders and leading scientists about ways to improve the reputation of pharmaceutical industry research and have participated in initiatives to harmonize reporting by physicians, investigators, and others who have financial relationships with industry and other conflicts of interest.  Numerous high-profile reports involving some of the world’s largest and previously most well-respected companies have detailed serious concerns about manipulation and misrepresentation of data from industry-sponsored research….   Voluntarily limiting direct-to-consumer advertising until postmarketing studies are completed would send an important signal that pharmaceutical companies are prioritizing patient safety.

But is this last step really going to happen “voluntarily“?   Not on your life!  I will never forget the initial advertising campaign for the launch of the HEARTBURN drug, Nexium.  The ads purposefully did not reveal what the drug was supposed to be taken for, but simply told us over and over again that “The purple pill is coming, the purple pill is coming — ask your doctor if the purple pill is right for you.”  No; with hundreds of billions of dollars at stake, and a daily advertising budget of tens of millions of dollars (the August 2012 issue of BMJ said that drug companies are spending nearly 20 times more on advertising than R&D), we can not count on change from Big Pharma —– unless it’s change for the worse.  This is why I have been telling you that it is all up to you.  If you do not take care of your own health (HERE), you will be viewed as a giant dollar sign to the Medical / Pharmaceutical Industry

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