Indian Journal of Pharmacology Home 

[Download PDF]
Year : 2017  |  Volume : 49  |  Issue : 2  |  Page : 211--212

Fact or fiction? What healthcare professionals need to know about pharmaceutical marketing in the European Union

Pathiyil Ravi Shankar 
 Department of Pharmacology, American International Medical University, Gros Islet, Caribbean, Saint Lucia

Correspondence Address:
Pathiyil Ravi Shankar
Department of Pharmacology, American International Medical University, Beausejour Road, Gros Islet, Caribbean
Saint Lucia

How to cite this article:
Shankar PR. Fact or fiction? What healthcare professionals need to know about pharmaceutical marketing in the European Union.Indian J Pharmacol 2017;49:211-212

How to cite this URL:
Shankar PR. Fact or fiction? What healthcare professionals need to know about pharmaceutical marketing in the European Union. Indian J Pharmacol [serial online] 2017 [cited 2022 Sep 28 ];49:211-212
Available from:

Full Text


Publisher: Health Action International

Edition: First

pp: 61

Can be downloaded for free from

Pharmaceutical promotion has a major influence on prescribing behavior of physicians. Recognizing the fact that education of healthcare professionals (HCPs) does not adequately prepare them for interacting with the pharmaceutical industry, a number of initiatives have been undertaken recently. Health Action International and the World Health Organization had previously published a book about understanding and responding to pharmaceutical promotion (published in 2009). While the primary focus of the present publication is on the countries of the European Union (EU), most sections will be of interest to educators and useful to educate healthcare students in other countries including India.

The book is divided into four main sections: promotion across the pharmaceutical product lifecycle, pharmaceutical marketing, what protects HCPs from unethical behavior by pharmaceutical companies, and conflicts of interest. The chapter on promotion across the lifecycle of a pharmaceutical product introduces the concept of drug life optimization and how to promote and maintain sales during the period when the patent on a drug is running out or has expired. The book highlights the adverse effects of lack of transparency of clinical trial data through the case study of the drug, oseltamivir (Tamiflu). The activity at the end of this chapter on creating your own marketing campaign for a drug across various stages of its lifecycle introduces participants to various promotional tactics.

The chapter on pharmaceutical marketing was of special interest to me. While marketing their products, pharmaceutical companies leverage some important characteristics of doctors and other HCPs. Among these are HCPs are motivated by better patient care, are pressed for time, HCPs respect the scientific process and outcomes, they are often overwhelmed by the choice and availability of pharmaceutical products, and many HCPs believe that while they are not personally influenced by promotion their colleagues are. The first step toward critically appraising pharmaceutical promotion is to accept that HCPs are human and susceptible to unconscious bias. Sales representatives are a powerful marketing tool, and the information presented by them has been often shown to be biased. This is of concern as many doctors rely on representatives as sources of medicine information.

Clinical practice guidelines play an increasingly important role in the practice of evidence-based medicine. However, studies have revealed conflicts of interest among authors of these guidelines turning them into a marketing tool for companies. The box on red flags for clinical guidelines will help readers critically appraise the independence and objectivity of these guidelines before using them in their practice. Companies are investing heavily on digital marketing campaigns using product websites, search engine optimization, and social media campaigns. The book mentions companies are creating self-diagnosis applications (apps) for patients and information apps for doctors. Digital marketing reinforces the direct contact of the industry with patients. Market expansion strategies including disease mongering, promoting off-label uses of medicines, and adherence programs for expensive medicines are described. This subsection is a significant addition to the strategies described in the previous book. These strategies are likely to be increasing used in developing countries also. The chapter activity is to make a list of promotional activities which the student has been exposed to and how these situations might look or feel and how the student might respond to them.

The next chapter discusses EU codes, individual country laws incorporating these codes, and voluntary self-regulation by pharmaceutical companies. Self-regulation does not work even in developed European countries. Educators elsewhere could focus on the laws regulating promotion in their own countries/regions and how these laws can be further strengthened to protect HCPs and patients.

The chapter on conflicts of interest highlights the fact that many doctors are not fully aware of the extent to which exposure to promotion can compromise the integrity of their clinical decision-making process. The “front page” test described is a good one to follow, and the activity “The change starts now” involves a group creating their own charter for behaviors regulating their interaction with the industry. The annex provides links to useful contacts and websites, and the detailed bibliography at the end will be useful for obtaining further information.

The book has been well designed and produced with “action pictures” of medical students. Diagrams and “boxes” and the case studies of various drug advertisements/marketing campaigns add to the information content. This book will be useful to all teachers interested in teaching their students to respond appropriately to promotion. Laypersons with interest in this topic may also find the book of interest.