Advertising

The last thing a doctor wants to admit is his or her being heavily influenced by advertisements of the pharma business. After all, medical doctors' prescribing behaviour is supposed to be pretty neutral and scientific.

But the awkward reality is that when it comes to pharmaceutical marketing strategy or advertising, doctors' neutrality aren't difficult to undermine. Not everyone believes in this. In no corner of doctors' mind, too, is there even a vague notion that they can fall trap to marketing of gangbusters business.

This is perhaps the good reason I have to read Patrick Radden Keefe's book, Empire of Pain. You should, too. The New Yorker staff writer will tell you how doctors are being influenced by the marketing to keep prescribing Valium, and then a far more dangerous drug OxyContin.

The book brings my memory back to a short article I published twenty years ago. That's the year when I could afford more time in the library during my once-in-a-lifetime overseas training in Montreal. As it happened, I had a chance to dig out four major medical journals targeted for family practitioners (American Family Physicians, Canadian Family Physicians, Journal of Family Practice, and Postgraduate Medicine). Meticulously, I counted the number of pages and frequency of pharmaceutical advertisement to anti-bacterial drugs between calendar years 1984 and 2002.

To the casual observer, rising frequency of advertisement for an antibiotics class called fluoroquinolone, from zero to 37.5 percent, might have appeared to be nothing remarkable. But the interesting finding of mine is that there was strong correlation between such advertisement frequency and the contemporary national fluoroquinolone drug resistance rate to the bacteria, Streptococcus pneumoniae, that commonly invade our lungs and cause middle-ear infection. The two nearly identical curves go in tandem, one following another. The more advertisements in the pages of prestigious journals, the more use (or over-use) of fluoroquinolone antibiotics, and the more antibiotic resistance.

Truly a fact more than chance.