Doctors as decision makers are not some monolithic block of individuals who are super educated about every product on the market and every piece of data. Just developing awareness of new drugs is a huge job. I'd say less than 5% of doctors are cutting edge enough that they require no additional education on new drugs.
The best story I can tell was from a friend who worked at a drug company that sold a hepatitis C drug. Once Gilead's drug came out, this company basically decided to discontinue their drug. Incredibly, there were doctors out there still ordering the old drug. The company had to send reps out to these doctors to tell them to stop ordering it. Continuing to use it made zero sense at all.
And there is plenty of research demonstrating that this is exactly what they do, and that doctors are indeed swayed by it, because, as you say, they don't have the time to do keep up with it all on their own.
And yes, there is a fundamental difference to consider here: My doctor has a fiduciary responsibility to do what's best for my health, to the best of their ability, and drug marketing compromises that. By contrast, nobody has any fiduciary responsibilities related to which brand of toilet paper I use.
There will be those that don’t change their practice ever once they graduate (seen a few).
Things get more complex when you have dozens of treatments for a condition with no clear winner.
Before I got in the industry I thought “what the hell does marketing do?”. Then once I saw what they do, I realized, no, most drugs don’t sell themselves, there is too much inertia for doing the same old thing.
If you develop yet another blood pressure drug or cholesterol drug and want GPs to prescribe it, you're going to have an uphill battle.
A blockbuster drug for HepC (where treatments before weren't particularly effective and had ugly side effects) will have a much easier time becoming well known amongst the specialists that treat the disease.
The government isn’t going to get away with hiring entire teams based on looks and then have a marketing line item for free fancy lunches for people that are definitely not starving.
Choosing Wisely is a broad approach that is somewhat like you described.
Other things that exist to counter this bias are competitors, who will provide a different perspective and most importantly, the FDA that regulates all pharmaceutical promotion for accuracy and will quite swiftly drop the hammer on a company that bends the rules.
Then you bundle all that up with the various studies that show that doctors(as with all professions) do a poor job with continuing education so that they are further inclined to take the recommendation from the pharma reps(which can be seen in the roots of the opioid crisis), I don't think we're in a very good place from a regulatory standpoint.
If memory serves me right, the theory is that it makes you overestimate your ability to stay objective and unaffected, so you're effectively lowering your guard, or something along those lines.
The job of the marketing department isn't "best drug for patient". That's the doctor's duty. The marketing department is there to bring awareness of the product to both doctor and patient. There is no conflict of interest at all.
Look at car ads. Do they say "The new 2019 models are available"? A few do. Do they say "This car gets better gas mileage" or "This car is safer"? A few do. Most say "If you drive this car, you'll get the hot girl". That's not "educating consumers". That's trying to make consumers want your product on the basis of something completely unrelated to your product.
And yes, I fear that marketing pharmaceuticals may in fact not be different from marketing any other product.
A few of the negative findings:
-Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked.
-In addition, about 75 percent of physicians surveyed believed that DTC ads cause patients to think that the drug works better than it does, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads.
And positive findings:
-Many physicians thought that DTC ads made their patients more involved in their health care.
-Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit.
-The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated.
The introduction is the most juicy bit as the particular article I found is about intra-sex competition but states a few interesting studies in their introduction about being desirable to women.
In short what I skimmed so far related to this idea is:
"And indeed, a man who was seated in a luxury car was perceived
as more attractive by women compared to the same man seated
in a nonluxury car (Dunn & Searle, 2010). Hence, men appear
to use showy spending to attract women in intersexual competition contexts. Sundie et al. (2011) further revealed that men’s
flaunting of luxury goods signals their desirability as a shortterm (rather than long-term) mate."
Personally, I don't car about any of this. However, academically (from an evolutionary psych. view, lol): yes, men are seen as a more desirable mate!
If this conclusion is also actually true (and not subject to whatever ails the field of psychology) then I'd chalk it up to most of humanity being vain and if you want to get vain people you need to be the vainest of them all and get the sports car, the fancy house, other desirable 'high value' women in pictures and all that jazz. Though, why not just immediately go for the private helipad and private jet with built-in Jacuzzi? Nothing attracts as much as offering young people in general a trip around the world in pure luxury! Or so I presume. So don't buy the sports car. Buy the helipad with helicopter on top.
Title: What If the Rival Drives a Porsche? Luxury Car Spending as a Costly Signal in Male Intrasexual Competition
Surprised the PC Police haven't demolished you for pointing out that, on average, women are attracted to men who convey wealth (even though it's blatantly obvious).
> Personally, I don't car (sic! also no pun intended) about any of this. However, academically (from an evolutionary psych. view, lol): yes, men are seen as a more desirable mate!
So first, I see evolutionary psychology as a joke and I don't care about the research because I think it's all lies anyway. I'm a bitter man when it comes to the promises of psychology being truthful about how humans think (the field has too many issues).
Secondly, I simply quoted research. And remember from point 1, distanced myself from that opinion.
Thirdly, in my experience I never needed to flaunt my wealth in order to attract women. I think the same is true for most if not all of my friends (both sexes). Disclaimer: I'm Dutch (maybe culture is a thing).
You and I must be watching different commercials, because I see far more of the former.
I think it's changed a lot since the 60s and 70s. Cars are seen as more utilitarian now, and younger people don't even care about getting their license, let alone being concerned with "what you drive".
Plus, this classic Scrubs clip describing a particularly chauvinistic (but truth-in-television) take on the practice:
As an aside, it's insulting to preface a rebuttal with, "this may come as a shock to you".
I do agree with you that pharmaceutical marketing isn’t fundamentally different from marketing other products. Although my conclusion from that is not that pharmaceutical marketing is therefore good.
I often ask foreign expats in America about the strangest aspect of American culture in their opinion. Believe it or not, pharmaceutical advertising is one of the most common answers I get.
That's how it is, in practice.
But some of us take that Hippocratic Oath thing seriously.
A lot of marketing does not seem very educational and more manipulative.
Most advertising is more about triggering emotions and using other cognitive dark patterns than educating anyone.
Personal and non-personal promotion is how it’s done in Europe.
Really? You don't see the difference between marketing, say, a car or a smartphone, and marketing a drug that treats a life-threatening condition?
Perhaps you should think about this subject a bit more deeply.
>> I'd say less than 5% of doctors are cutting edge enough that they require no additional education on new drugs.
What do you base this on? Do you have some citations to support it?
Chronic pain (and a whole host of other issues) aren't life threatening. Until the mid 20th century people just lived with chronic pain and tons of other things. Look at the kinds of TV ads you see, they're for drugs that minimize the symptoms of some some negative, but not life threatening thing. These are not essential products. They're luxuries of modern life that we consider to be nearly essential. Depending on one's specific situation having a smartphone or car may actually be more "essential" to daily life than having one's condition treated.
As an aside, drugs that actually save lives don't seem to get marketed much.