Healthy Skepticism Library item: 3111

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Melrose D.
Bitter pills: medicines and the Third World poor
1982;
http://publications.oxfam.org.uk/oxfam/display.asp?K=9780855980658&cat=090,280&ob=SORT_DATE/d&m=43&dc=220

Abstract:

The evidence suggests that heavy promotion has to a great extent been responsible for excessive and irrational prescribing in developing countries. Sales representatives are heavily used and there is a much greater concentration of detailers to doctors in developing countries than in industrialized ones. Although detailers from multinational companies are sometimes better trained than those from domestic companies there are still serious problems with detailers from all companies. Promotion is designed to create brand loyalty and the intrinsic superiority of products from brand name companies. This has the effect of driving up costs since these products are more expensive than generic ones. There are blatant examples of double standards in the quality of information that is given about products in developed and developing countries. Companies give lavish gifts to doctors to encourage prescribing as well as distributing free samples of their products. Advertising directly to the public, which is common in some developing countries, encourages people to see medicines as the key to health. There are few meaningful controls on advertising standards in developing countries. Manufacturers try to justify the misleading drug promotion by stressing the differences in opinions and regulations that exist from one country to another, but this ignores the lack of resources in developing countries to control promotion and the fact that these countries rely on information that they receive from manufacturers in order to make their decisions.

Keywords:
*analysis/developing countries/quality of information/quality of prescribing/sales representatives/gift giving/promotion costs and volume/consumer drug prices/ domestic companies/ research-based manufacturers/ direct-to-consumer advertising/ DTCA/ drug names/ATTITUDES REGARDING PROMOTION: INDUSTRY/ETHICAL ISSUES IN PROMOTION: GIFT GIVING/EVALUATION OF PROMOTION: COMPARISON BETWEEN DEVELOPING AND DEVELOPED COUNTRIES/EVALUATION OF PROMOTION: DETAILING/EVALUATION OF PROMOTION: DIRECT-TO-CONSUMER ADVERTISING/INFLUENCE OF PROMOTION: ACCESS TO ESSENTIAL DRUGS/INFLUENCE OF PROMOTION: CONSUMER DRUG COSTS/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/PROMOTION AND HEALTH NEEDS: PROMOTION IN DEVELOPING COUNTRIES/PROMOTIONAL TECHNIQUES: DRUG NAME/VOLUME OF AND EXPENDITURE ON PROMOTION