In Healy’s article, “Shaping the Intimate: Influences on the Experience of Everyday Nerves”, the ways in which pharmaceutical marketing can shape the culture of disease, the practice of medicine, and culture of the general population is discussed. I was taken by the degree to which drug companies can exercise control over medical professionals through marketing practices. For example, by rebranding tranquillizers as anxiolytic antidepressants, the pharmaceutical industry was able to remove the negative association of dependence from SSRIs such as Paxil. Despite the fact that SSRIs were still being prescribed, the term dependence was successfully removed from psychiatrists vocabulary (and patient conversations, presumably) due to strategic marketing (339-340). Here it appears the best interest of the patient failed to be protected due to the marketing efforts of drug companies.
In marketing to the general population, clinical trials are used by drug companies to transform experiences of a certain subset of the population into homogenized experiences (236), enlarging the audience to which a product can be marketed. Healy argues this is also present in the proliferation of risk marketing: he points to the marketing of risk factors (such as elevated blood pressure) over that of specific diseases (like strokes or heart attacks) in order to sell antihypertensives (237). Not only does this make it easier to obtain approval to sell the drugs, but marketing risk factors also captures a larger audience than would marketing the disease itself. In the case of antihypertensives, the medicalization of risk factors allows for massive profits even though “these products…may have little impact on the wider state of the health of the population” (237). Here we see a disease culture being formed: the population is made aware they have a ‘problem’ (a risk factor) by the very company who happens to have the solution.
This manipulation allows pharmaceutical companies to create and market disease to popular culture. In making disease fashionable through the use of celebrity endorsement or awareness campaigns, advertising the solution (the drug) comes second to the advertisement of the problem (the disease). In short, the conclusion drawn from Healy’s article is that drug companies are in the business of marketing and selling disease: a creation of a drug necessitates the creation of a disease that makes the drug medically necessary where it was not before. What concerns me now is the strength and ability of regulators to prevent conflicts of interest between actors and negotiate regulations for marketing that is in the best interest of the patient.
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