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Under the influence - Los Angeles Times

Under the influence
Savvy marketing whets our appetite for prescription pharmaceuticals. Consumers, doctors, researchers -- no one is immune
By Melissa Healy, Los Angeles Times Staff Writer
August 6, 2007

FOR many Americans, a doctor's decision to prescribe medication is something of a sacred transaction. A physician considers the patient and symptoms and chooses the best drug for the job, drawing upon years of training and clinical experience. It is an exchange conducted in a hushed sanctuary, far from the heat and noise of the marketplace -- a place where cool judgment reigns.

That sanctuary has been breached. Today, drug manufacturers do everything in their considerable power to ensure that their brand-name prescription medications are on the lips of patients and in the minds of physicians every time the two meet across an exam table. A growing chorus of critics says their efforts have begun to rewrite the dialogue between patient and doctor, influence physicians' judgments and open the act of prescribing to forces more profit-minded than sacred.

In 2006, drug-makers spent almost $5 billion to reach out to consumers with direct advertising. But the glossy magazine ads and buzz-generating TV spots are just the most visible parts of a campaign to build and nourish markets for brand-name prescription products. The world's pharmaceutical companies spend an estimated $19 billion annually to woo doctors. They sponsor teaching programs and research at universities across the country, gaining goodwill along the way. They give money to patient groups. They hire public relations firms to share patient stories of illness and triumph.

In a nation that consumed $279-billion worth of prescription medications in 2006 -- spending 80% of that on brand-name products -- their efforts appear to be paying off. Americans filling a prescription choose brand-name products 37% of the time, even though three-quarters of all prescription drugs in the U.S. are available in cheaper generics.