Tuesday, March 31, 2009
Traditional Pharma Bashing? Or Thinly Disguised Paternalism?
Last Thursday’s article in the New York Times, “Online Age Quiz is a Window for Drug Makers,” is a prime example of why pharmaceutical companies are cautious in their embrace of new marketing technologies.
Industry critics are quick to assume that any new patient initiative somehow involves trying to trick the consumer. New marketing ventures invariably end up being front-page news.
The article throws dispersion on practice by the RealAge organization of letting pharmaceutical companies send relevant emails to patients based on the information in the RealAge database. RealAge helps patients calculate their true biological age based on an extensive health and wellness questionnaire. All the emails are sent with strict adherence to privacy guidelines.
In some cases, pharmaceutical companies let consumers know that they may have a medical condition that should be checked out by a physician. According to Andy Mikulak, vice president for marketing at RealAge, “Our primary product is an e-mail newsletter series focused on the undiagnosed at-risk patient, so we know the risk factors if someone is pre-hypertensive, or for osteoarthritis.”
But beyond the usual pharma-bashing, there is something even more pernicious in the article. Namely, a dangerously paternalistic attitude towards patients and their ability to make healthcare decisions. In the article, Peter Lurie, the Deputy Director of the Health Research Group at Public Citizen, objects to this practice because, “The company can … create anxiety even though the person does not have a diagnosis. He misses the point that people have signed up for RealAge precisely because they want to take a proactive stance towards their health, even if it involves some worry.
Mr. Lurie’s statement patronizingly assumes that people shouldn’t play a role in the diagnosis of their illnesses because it might cause them stress. His comments imply that consumers should passively wait for the doctor to tell them when to worry.
What he is ignoring is that consumers are surprisingly good at determining what ails them. According to an FDA study of Physician attitudes towards DTC advertising released in 2003, when a patient asked about a drug, 88% of the time they had the condition the drug treated.
Going beyond facts and figures, another New York Times article earlier in the week, shows the folly of this passive approach for patients. In the article, “Botox Frees Muscles for Stroke Patients in the Know,” we meet Francine Corso, a stroke victim whose life was changed because she learned of a Botox procedure that could significantly increase her ability to perform everyday tasks. So where did Francine hear about this treatment? “I heard about it from Dr. Max Gomez on NBC,” she said.
According to Dr. David M. Simpson, a professor at Mount Sinai Medical Center in New York, she could have had to wait a long time to be told about the treatment by a medical professional. He estimates that, “only about 5% of the stroke patients who could benefit from its use ever get it.”
DTC critics fall back on unsubstantiated theories that patient involvement costs the health care system money by resulting in unneeded prescriptions and office visits. In fact, patient activism may be the very thing the system needs. Health guru Dr. Roizen suggests the only way spiraling healthcare costs will be brought under control is to emotionally engage consumers in making needed lifestyle changes, including taking prescription medicines.
Most of the A&U studies I have seen in my career across multiple disease states suggest we have a long way to go in activating patients. In category after category, the proactive patient group only ranges from 15-30% of total sufferers. Denying people information that might save their lives, just because it comes from a politically unpopular industry, seems foolhardy to me.