Pharmaceutical Marketing

Ph sleeveaceutical trade Merck Merck has gone beyond excogitateing and selling prescription pharmaceuticals. It formed joint ventures in 1989 with Johnson & Johnson to sell tout ensemble over the-counter pharmaceuticals in 1991 with DuPont to puff basic search, and in 2000 with Scherigng-Plough to develop and market new prescriptions medicines. In 1997, Merck and Rhone-Poulenc S. A. (now Sanofi-Aventis S. A. ) combined animal health and bird genetics business to form Merial Limited, a fully integrated animal health company.Fin in ally, Merck purchased Medco, a position order pharmaceutical distributor, in 2003, and Sirna Therapeutics in 2006 (Kotler & Keller, 2012, p. 43-44). For grimeing strategies to be successful and brand value to be created, consumers must be convinced thither ar meaningful differences among brands in the crossing or avail category. Brand differences frequently related to attributes or benefits of the product itself . . Merck has attract ( its) product categories for decades, due in deduct to continual innovation (Kotler & Keller, 2012, p. 243).Merck has donated $100 million or to a greater extent(prenominal) than to charities in a course of acquire (Kotler & Keller, 2012, p. 632). bursting charge Statements Ex. Japan Both pharmaceutical and biotech companies are starting to remove procedurenership a core qualification (Kotler & Keller, 2012, p. 52). Intro Michael Dawson, author of The Consumer Trap, states that the business of trade, a trillion-dollar a-year industry, is a social, economical, environmental, and unfriendly fol lowly on Ameri elicits forthwith as it continues to soak up economic and environmental resources and dominate the ain lives of citizens (Dawson, 2005, p. ). Dawson argues that corporate America is fueled by a continuous marketing race that manipulates peoples perceptions and actions of goods into thinking the economy is out to distribute ones pleasures and happiness, when in all reality, is totally out to serve the demand of business today (Dawson, 2005, p. 1). It is critical that the U. S. government recognizes that intelligently focused nutrition-related efforts are important in availing lead Ameri butt joints of all ages to lead healthier spiritednessstyles.Marketing Nutrition arrays how simple solutions can save lives. Congressman Timothy V. Johnson, joined States dramaturgy of Representatives (Wansink, 2007, p. 1). There are enormous economic dividends for health burster providers, public health institutions, and commercial regimen companies if we are successful in doing this. Dr. David Mela, Expertise Group Leader, Unilever Health Institute(Wansink, 2007, p. 1). Marketing = A mechanism to help chemists develop, communicate, and sell future pharmaceutical services to consumers (Grauer, 1981, p. ). Pharmaceutical marketing is an element of an randomness continuum, where research concepts are transformed into practical therapeutic tools and wher e nurture is progressively layered and make much usable to the health care dust (Levy, 1994, p. 1). Provides an informed choice of carefully characterized agents (Levy, 1994, p. 1). marketing assists physicians in matching dose therapy to individual forbearing unavoidablenesss (Levy, 1994, p. 1).Pharmaceutical marketing is presently the close to organized and comprehensive information system for updating physicians about the availability, safety, efficacy, hazards, and techniques of using medicines (Levy, 1994, p. 1). pharmaceutical marketing strategies can negatively affect two- the end consumers or the patients and the health care profession (Need of new-made Pharmaceutical Marketing Strategies, 2010, p. 1). Also, the announce strategies included in the marketing plan of any pharmaceutical company is non direct to consumer (Need of New Pharmaceutical Marketing Strategies, 2010, p. ). all pharmaceutical marketing strategy targets the health care professionals or the D octors who in turn prescribe the doses to the patients (end consumers) presumable to pay for the products (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). However, a few countries (till date two countries- New Zealand and coupled States) al down in the mouth Direct-to-consumer advertising (DTC advertising) for pharmaceutical products (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). Pharmaceutical Market Trends 2010. Pharmaceutical & dose Manu situationurer Resources.Retrieved from http//www. pharmaceutical-drug-manufacturers. com/articles/pharmaceutical-market-trends-2010. html The global pharmaceutical is forecasted to make a earthshaking growth of about 4 6%, exceeding $975 one thousand million, with global pharmaceutical market sales expecting to grow at a 4 7% compound annual growth rate (CAGR) done 2013, based upon global macroeconomy as thoroughly the ever-changing combination of innovative and mature products apart from the rising mould of healthcare access and mount on market demand (Pharmaceutical Market Trends 2010, p. ). pharmaceutical sales are growing at a fast rate in India, China, Malaysia, South Korea and Indonesia due to the rising disposable in happen, several health indemnity schemes (that ensures the sales of mark drugs), and intense competition among top pharmaceutical companies in the region (that has boosted the availability of low cost drugs). India 3rd Largest Producer of Pharmaceuticals Across the World- is already a US$ 8. 2 Billion pharmaceutical market.The Indian pharmaceutical industry is further expected to grow by 10% in the year 2010. (Pharmaceutical Market Trends 2010, p. 1). The development of infrastructure and rapidly changing regulations in the Middle East are existence seen as the cause of its growth. Presently South Africa, Saudi Arabia and Israel dominate the regions pharmaceutical industry due to their break out infrastructure and regulatory environment. However, The Middle East pharma market depends on imported pharmaceutical drugs and therapeutics.The governments of countries in this region are taking measures to raise their domestic production finished heavy investments in the pharmaceutical industry (Pharmaceutical Market Trends 2010, p. 1). Pharmaceutical Drugs Trends of fastest expected growth consist of anti-Diabetic Drugs and those for cardiovascular diseases, due to the changes in demographics and lifestyle with anti-hypertensives drugs will dominate the global cardiovascular market with a market share of tight 50% (Pharmaceutical Market Trends 2010, p. 1). StrategyThe pharmaceutical companies traditionally adopt four major(ip) marketing strategies for promoting their products gift drugs as free samples to doctors/ Gifts that hold the company logo or details of one or ternary drugs, providing details of their products through journal articles or opinion leaders and Sponsoring continuing medical reproduction (Need of New Pharmaceutical M arketing Strategies, 2010, p. 1). Pharmaceutical representatives, also popularly known as medical representatives, are the major pharma marketing strategy for marketing drugs directly to the physicians.Typically, the expense of this sales force of any pharmaceutical company comprises anything ranging from 15-20% of annual product r until nowues (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). Marketing Nutrition laissez passers a win-win proposal for all concerned. Insightful companies, health professionals, and policy makers can lead the way . . . in helping people eat better and enjoy food more. Dr. James O. Hill, Director of Human Nutrition, University of Colorado Medical check (Wansink, 2007, p. ). Take profit of future growth opportunities. These growth opportunities will be realized from unmet health-care needs and changing consumer life style trends and values (Grauer, 1981, p. 1). Dispensing and drug-knowledge-distribution pharmaceutical services are reviewe d by a product life cycle psychoanalysis of sales profits versus metre (Grauer, 1981, p. 1). A marketing mix for new pharmaceutical services is developed consisting of service, price, distribution, and promotion strategies.Marketing can encompass those key elements necessary to meet the organizational goals of pharmacy and provide a systematic, discip stage businessd approach for presenting a new service to consumers (Grauer, 1981, p. 1). The be of pharmaceutical marketing are substantial, but they are typical of laid-back-technology industries that must communicate important and complex information to sophisticate users. These costs are offset by savings resulting from proper use of medicines and from lower drug costs owing to price competition (Levy, 1994, p. 1). oint to the Food and Drug Administration (FDA) and find comfort in the fact that this agency is tasked with regulating drug advertising. only 8% of advertisements are in violation of regulations. at least(prenomina l)(prenominal) one of the 11 advertisements in the April issue of the ARCHIVES is belike to be delusory and, thus, provide authorizationly harmful information. In fact, the FDA, according to David A. Kessler, MD, commissioner, spends most of its time developing the package insert and not, as assert by Levy, preapproving advertising. According to Kessler, Except under very special circumstances, the agency does not eview or authorize advertising and promotional materials before their dissemination by a drug firm Furthermore, Kessler states that an enormous potential exists for mis trail adver tisements to reach the physician and mould prescribing decisions. (Shaughnessy, Slawson, Bennett, 1994, p. 1). Gifts Giving drugs as free samples to doctors/ Gifts that hold the company logo or details of one or multiple drugs, A study was done in 1995 to property the outcome of a patients perception of pharmacy marketing regarding physicians accept gifts from the pharmaceutical indust ry.The impersonal of this study was to examine patient perceptions of professional appropriateness and the potential impact on health care of physician acceptance of gifts from the pharmaceutical industry, via a random telephone suvey of 649 adjults living in the state of Kentucky. Through the random sampling, the outcome of the survey was that Patient awareness of officeuse gifts (eg, pens, notepads) and personal gifts to physicians from the pharmaceutical industry, patient word picture to office-use gifts, and attitudes toward physician acceptance of both office-use and personal gifts. Mainous, Hueston, Rich, 1995, p. 1). Eightytwo percent of the respondents were aware that physicians received office-use gifts, while 32% were aware that physicians received personal gifts. S tied(p)ty-five percent reported receiving free samples of medication from their physicians. Compared with office-use gifts, more respondents believed that personal gifts to physicians bring in a negative f orce play on both health care cost (42% vs 26%) and tonicity (23% vs 13%). After controlling for demographic variables, as well as awareness and exposure to physician gifts, individuals with at least a high gear school teaching were 2. times as probably to believe that personal gifts shit a negative kernel on the cost of health care and 2. 3 times as likely to believe that personal gifts would have a negative pitch on the step of health care. (Mainous, Hueston, Rich, 1995, p. 1). Conclusions These results suggest that the public is generally uninformed about personal gifts from pharmaceutical companies to physicians. If public perception regarding the objectivity of the medical profession is to serve as a guide, these findings suggest a reevaluation may be in order for guidelines regarding physician acceptance of gifts from the harmaceutical industry (Mainous, Hueston, Rich, 1995, p. 1). The World Health Organization, the American Medical Association, the American College of Physicians, and the Pharmaceuticals Manufacturers Association have also published guidelines on perks to physicians from the drug industry. The bottom line is that all these guidelines are unbidden, and physicians have continued to vote with their feet. (Shaughnessy, Slawson, & Bennett, 1994, p. 1). debatable 1962 FDA amendments.Just before 1962, congress studied and cerebrate that because of overt protection, heavy promotion by the drug companies, consumer ignorance, and minimal incentives for physicians to be concerned with cost, drugs of dubious quality and unnecessarily high expense were being prescribed by physicians, criticisms that sound remarkably familiar even today. Up to that point, the FDA had only inevitable proof of safety, which dated can to the origins of the modern drug era and the 1938 Food, Drug, and cosmetic Act (Shaughnessy, Slawson, & Bennett, 1994, p. 1).Discussions about the influence of pharmaceutical promotion on physicians often focus on gifts a nd payments of relatively large economic value. This focus is also evident in ethics guidelines addressing pharmaceutical promotion among some professional medical societies. 1 The underlying assumption is that downcaster gifts are unlikely to exert influence on prescribing decisions. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). In contrast, a substantial body of marketing and psychological science literature suggests that even idle items can exert influence irrespective of economic value.For example, adding a small gift such(prenominal) as personalized mailing labels to a solicitation for donations has been shown to importantly increase contributions. 2 In pharmaceutical promotion, small gifts are often tethered to stigmatization efforts, as items such as pens and coffee mugs display logos. out from the intrinsic value of promotional items, branded materials strengthen brand awareness and build brand impartiality through a mannequin of largely unconscious but powerful me chanisms. 3 Nonverbal information about the brand, such as symbols or logos, is often more influential than verbal cues. crockeder brands have a memory encoding and storage advantage over abstruse brands,5 which facilitates the formation of strong positive associations with the brand. Strong branded products are more often in a top-of-mind set of alternatives for consumers to consider. 6 Strong brand awareness provides a justifiable reason for choosing a particular brand. 7-8 This research suggests that small branded promotional items should increase favorable attitudes for the brand being promoted.We are unaware of studies that test these effects in a clinical context with health professionals, but many physicians, because they are medical experts, believe they are not susceptible to these influences. 5, 9-10 In one survey, just 8% of physicians believed they were susceptible to influence by marketing items such as branded pens, whereas 31% of patients felt these items could infl uence physicians. 9 The guidelines of the American Medical Association regarding gifts to physicians from industry reflect this belief of lack of susceptibility by permitting gifts of minimal value. 1 (Grande, Frosch, Perkins, & Kahn, 2009, p. ). The study used a randomised experimental design. Participants were third- and fourth-year medical students at the University of Pennsylvania aim of medicament (Penn) and the University of Miami Miller School of Medicine (Miami). We selected these institutions because of their differing policies regarding interactions between trainees and pharmaceutical company representatives. The University of Pennsylvania has restrictive policies in place that prohibit most gifts, meals, and samples while Miami continues to permit such marketing practices. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). 007-2008. Study participants were assigned to a control or ready term based on their day of enrollment. Participants assigned to the primed condition w ere exposed to Lipitor (atorvastatin) branded promotional items immediately prior to completing a computer-based study instrument. These exposures included Lipitor logos on a clipboard (used when signing in to the study room) and notepaper (used to provide participants with their study identification number). Participants assigned to the control condition completed the same procedures but with a plain (nonbranded) clipboard and notepaper.Randomization was conducted by day in order to fend off contamination of conditions. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Participants were told they were enrolling in a study about clinical decision making under change conditions (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Our study was designed to measure the influence of exposure to branded promotional items on relative attitudes toward 2 lipid-lowering statins. We examined differences in attitudes toward Lipitor and Zocor (simvastatin) in our exposed (Lipitor promotional items) an d control gatherings.Lipitor is among the most promoted brand-name statins in the United States while simvastatin is available generically and considered to be nearly equally effective. The study outcomes included measures of covert and self-reported (ie, explicit) attitudes. (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Implicit attitudes were evaluated with the Implicit Association Test,11-15 a widely used tool in marketing and psychology research that is thought to be resistant to social desirability bias among research participants.Initial applications of the IAT, for example, demonstrated the sedulousness of racial and gender stereo events and prejudices, even in the face of strong conscious beliefs that such attitudes do not exist and strong social norms that dictate they should not exist. 16-17 Results from the IAT are a better predictor of intergroup inequality (eg, biased behavior against people of opposite races/ethnicities, gender, and sexual orientation based on ex isting attitudes and stereotypes) comparisond with manifestly similar self-report measures. 13 In recent years, the use of the IAT has been expanded to research focused on branding and marketing. 8-19 Further details regarding application and validity of the IAT have been published elsewhere13-15 a demonstration can be demonstrate at the Project Implicit Web site (https//implicit. harvard. edu/implicit). (Grande, Frosch, Perkins, & Kahn, 2009, p. 1). Explicit attitudes were assessed by self-report. Following the IAT, participants were asked to compare Lipitor and Zocor in 5 dimensions (superiority, preference, efficacy, safety, and convenience) a follow-up anonymous Internet-based survey that assessed their attitudes toward pharmaceutical marketing.The role was to measure differences in attitudes among students at the 2 schools given the differing institutional policies as a possible instructive factor(Grande, Frosch, Perkins, & Kahn, 200 Then there is the pharmaceutical indust rys holy grail of marketing the relationship between their sales representatives and medical doctors. To maintain this relationship, often called detailing, pharmaceutical companies spend a whopping $8,290 per doctor.The average family doctor receives 28 visits each week from drug reps, who provide free samples, explain new findings from company-sponsored drug trials, and demonstrate the latest innovation in their companys medical devices. Some doctors, reporters and public health advocates have distantseeing decried the pharmaceutical industrys seemingly endless attempts to buy goodwill among medical professionals. But insidious marketing campaigns quest to rebrand medical conditions as lifestyle choices, and the patients who suffer from them as consumers, have received little scrutiny. (Ebeling, 2008, p. 1). 9, p. ). providing details of their products through journal articles or opinion leaders Worse, the trend is seriously undermining the regulatory authority of the FDA. It s not move that profit-driven, cutting-edge marketing techniques have outstripped the government agency established to guide them. What is surprising is that public health advocates havent made pharmaceutical rebranding and off-label promotions of drugs and medical devices major issues. In December, the advocacy group Consumers Union sent a letter (PDF) to the FDA requesting tighter DTC advertising regulations on medical devices. Ebeling, 2008, p. 1). The December 2007 issues of the womens fashion magazines Allure and Harpers Bazaar both have multi-page spreads on non-surgical cosmetic procedures, including the array of injectable wrinkle fillers. The articles outlined the pros and cons of each filler, evaluating injection pain, cost per injection (most run between $500 and $800 per shot), and how yearn each lasts (Ebeling, 2008, p. 1). Dermatologist and anti-aging cream entrepreneur Dr. Patricia Wexler is featured prominently in the Bazaar story.Her remarks about each injectable reflect the marketing language of the brands themselves. When she is discussing Sculptra, for instance, she lines how the product acts as a trellis on which the collagen can grow a line marketers use to describe how the device works. She also repeatedly suggests what are off-label, unregulated product applications, such as using injectable fillers in the eye area, in the temples, in the jawline, on the cheekbones, and in the fine lines surrounding the mouth. Dr. Wexlers injectable filler romotions are especially credible among the target audience. Wexler regularly discusses non-invasive, anti-aging procedures on the Oprah Winfrey Show, the Today Show, and Good Morning America, and in the pages of Vogue and Marie Claire. The big pharma companies that make the injectable fillers likely dream of doctors touting their products and suggesting off-label uses for them in popular womens magazines. As the saying goes, they couldnt buy such good press but they probably did. (Ebeling, 2008 , p. 1). Dr. David J.Triggle, a pharmacologist at the State University of New York at Buffalo who has written about drug advertising, says a doctors endorsement should be scrupulously honest (Saul, 2008, p. 2). Dr. Robert Jarvik, known for the artificial heart he pioneered more than a quarter-century ago. began appearing in television ads two years ago for the Pfizer cholesterol drug Lipitor (Saul, 2008, p. 1). wipe to next paragraph The ads have depicted him, among new(prenominal) outdoorsy pursuits, rowing a one-man belt along shell swiftly across a mountain lake. When diet and exercise arent enough, adding Lipitor significantly lowers cholesterol, Dr. Jarvik says in the ad. Celebrity advertising endorsements are nothing new, of course. But the Lipitor campaign is a rarefied instance of a well-known doctors endorsing a drug in advertising and it has helped kindle a smoldering debate over whether it is appropriate to aim ads for prescription drugs directly at consumers. A Cong ressional committee, concerned that the Lipitor ads could be misleading, has said it wants to interview Dr. Jarvik about his role as the drugs pitchman.Some of the questions may involve his credentials. Even though Dr. Jarvik holds a medical degree, for example, he is not a cardiologist and is not licensed to practice medicine. So what, critics ask, qualifies him to recommend Lipitor on television even if, as he says in some of the ads, he takes the drug himself? (Saul, 2008, p. 1). Skip to next paragraphThe fellowship mission on Energy and Commerce is looking into when and why Dr. Jarvik began taking Lipitor and whether the advertisements give the public a counterfeit impression, according to John D.Dingell, the Michigan Democrat who is the committees chairman. It seems that Pfizers No. 1 priority is to sell lots of Lipitor, by whatever means necessary, including misleading the American people, Mr. Dingell said. Lipitor, the worlds single best-selling drug, is Pfizers biggest p roduct, generating sales of $12. 7 billion last year. But as it has come under competition from cheaper generic alternatives, Pfizer has used the Jarvik campaign, introduced in early 2006, to help protect its Lipitor franchise. wheresoever the Congressional inquiry leads, the controversy perils damaging Dr.Jarviks credibility and undermining his real medical mission. The Jarvik campaign was roll out the same year that Zocor, Lipitors chief competitor, became available as a generic drug that is widely considered about as effective as Lipitor but is sold at a fraction of the cost. (Saul, 2008, p. 1). Skip to next paragraph Criticism of consumer advertising of pharmaceuticals flared as an issue back in 2004, when Merck withdrew Vioxx, a heavily advertised painkiller, later on a clinical trial showed that it sharply change magnitude the risk of heart attacks and strokes.The pharmaceutical industry adopted voluntary guidelines the next year suggesting that companies delay advertising new products for an unspecified end after they freshman reach the market (Saul, 2008, p. 1). In early January, the U. S. House Committee on Energy and Commerce began investigating celebrity endorsements in television ads for brand-name drugs. These direct-to-consumer (DTC) ads have been controversial since the Food and Drug Administration (FDA) loosened the rules governing pharmaceutical marketing in 1997.Before Lipitor made headlines, there was Viagra. Pfizers Viva Viagra campaign was criticized by the FDA and organizations including the AIDS Healthcare Foundation, who said the DTC ads pushd inexpert use of the erectile dysfunction drug. One print ad suggested that Viagra be used to solemnize events such as the Super Bowl or New Years Eve. (Ebeling, 2008, p. 1). While troubling, DTC ads represent only 14 percent of pharmaceutical companies marketing budgets.By the time a 30- flake drug commercial airs, the company has conducted months of segmentation studies, held lashings of meetings to define the communication target (typically a woman, usually a mother, and of a certain income), and spent millions of dollars to develop the drugs brand and its market. This strategic marketing, which represents the remaining 86 percent of drug promotion expenses, should receive at least as much attention from regulators and lawmakers as DTC ads. (Ebeling, 2008, p. 1).While DTC ads seek to change patients behavior, pharmaceutical companies are more arouse in changing doctors behavior. Drug marketers work hard to persuade doctors to prescribe their branded drug over generics and other competitors, and to change other medical practices that limit company profits. To cultivate medical professionals, drug companies may retain a doctor as a spokesperson, position friendly medical thought-leaders in the media, or organize free events at posh resorts and expensive hotels to educate doctors about a new disease state (think Restless Leg Syndrome) or their latest drug.In 2000, the biggest 10 pharmaceutical companies spent $1. 9 billion on promotional events alone (Ebeling, 2008, p. 1). For example, the FDA found that Eli Lillys television broadcast advertisement for Strattera (atomoxetine) was false or misleading because it inadequately communicated the indication for the drug (attention-deficithyperactivity disorder) by means of competing visuals, graphics, and music presented concurrently. Similarly, serious risk disclosures were minimized for Strattera, the FDA said, by the distracting visuals and graphics (e. . , erratic camera movement, degenerate scene changes, and visual changes in point of view). In some other case, the FDA said Pfizers print advertisement for Zoloft (sertraline) was false or misleading because it omitted important information relating to the risk of suicidality in patients, a risk stated on the products label at the time the advertisement ran. (Donohue, Cevasco, & Rosenthal, 2007, p. 1). Drugs that are advertised to consumers are predominantly new drugs used to treat chronic conditions.Ten of the top 20 drugs, as ranked by advertising spending, were introduced in 2000 or later. Advertising campaigns generally begin within a year after the introduction of a pharmaceutical product, which raises questions about the extent to which advertising increases the use of drugs with unknown safety profiles. At least one pharmaceutical manufacturer (Bristol-Myers Squibb) recently announced a voluntary moratorium on direct-to-consumer advertising for drugs in the first year after FDA approval.And PhRMA, the industry trade group, has recommended that manufacturers delay such campaigns for new drugs until after health professionals have been sufficiently educated, although no details have been provided on how long a completion was deemed necessary. 20 Finally, in a recent study of drug safety, the Institute of Medicine recommended that the FDA restrict advertising for newer prescription drugs. 8 Our data show that a ma ndatory waiting period on advertising for new drugs would represent a dramatic departure from current industry practices.For example, the FDA found that Eli Lillys television broadcast advertisement for Strattera (atomoxetine) was false or misleading because it inadequately communicated the indication for the drug (attention-deficithyperactivity disorder) by means of competing visuals, graphics, and music presented concurrently. Similarly, serious risk disclosures were minimized for Strattera, the FDA said, by the distracting visuals and graphics (e. g. , erratic camera movement, quick scene changes, and visual changes in point of view).In another case, the FDA said Pfizers print advertisement for Zoloft (sertraline) was false or misleading because it omitted important information relating to the risk of suicidality in patients, a risk stated on the products label at the time the advertisement ran. (Donohue, Cevasco, Rosenthal, 2007, p. 1). direct-to-consumer advertising of prescri ption drugs on television. Such advertising has been criticized for encourage inappropriate use of medications and driving up drug spending. ,2 Concern that such advertising may lead to increased use of expensive medications was amplified by the introduction of a prescription-drug benefit in Medicare in 2006 (Part D). Studies of the effect of advertising on prescribing practices have shown that such advertising increases classwide sales, helps to avert underuse of medicines to treat chronic conditions, and leads to some overuse of prescription drugs. (Donohue, Cevasco, Rosenthal, 2007, p. 1). Direct-to-consumer advertising has also been controversial in light of postmarketing revelations regarding problems with drug safety.Specifically, clinical trials that are required for drug approval are typically not designed to detect rare but significant adverse effects, and contemporary methods of postmarketing surveillance often fail to connect adverse events that have a high rate of back ground prevalence with the use of particular drugs. After the market withdrawal of Vioxx (rofecoxib), a drug heavily promoted to consumers,6 critics called for the FDA to place limits on direct-to-consumer advertising, particularly for new drugs,7 a view that was reiterated in a recent report by the Institute of Medicine on the safety of medicines. (Donohue, Cevasco, Rosenthal, 2007, p. 1). Sponsoring continuing medical education describes the influence of sponsoring on the results, protocol and quality of drugs studies (Deutsches Aerzteblatt International, 2010, p. 1). The authors conclude that pharmaceutical companies exploit a wide variety of possibilities of manipulating study results. Apart from financing the study, financial links to the authors, such as payments for lectures, may tend to make the results of the study more booming for the company.Not only the results themselves, but also their comment, are significantly more often in accordance with the wishes of the spon sor. (Deutsches Aerzteblatt International, 2010, p. 1). In some publications, the authors detected evidence that sponsors from the pharmaceutical industry had influenced study protocols. For example, placebos were more frequently used in drug studies than was the case with respectively financed studies. On the other hand, some favourable effects were linked to financial support from the pharmaceutical industry.The methodological quality of studies with industrial support tended to be better than with autonomous drug studies(Deutsches Aerzteblatt International, 2010, p. 1). Most physicians must complete accredited continuing medical education (CME) programs to maintain their medical licenses, hospital privileges, and specialty board certifications. Data from the Accreditation Council for Continuing Medical Education (ACCME) show that CME is a $2 billion per year business in the United States that earns less than half its tax income from physician learners themselves. CME is incre asingly underwritten by commercial sponsors primarily manufacturers of drugs, biologic therapies, or medical devices that spend more than $1 billion per year in educational grants and other funding to cover more than half the costs for CME activities (Morris Taitsman, 2009, p. 1). In recent years, a number of studies have shown that clinical drug trials financed by pharmaceutical companies yield favorable results for company products more often than independent trials do. Moreover, pharmaceutical companies have been found to influence drug trials in various ways. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). create drug trials that were financed by pharmaceutical companies, or whose authors declared a financial conflict of interest, were found to yield favorable results for the drug manufacturer more frequently than independently financed trials whose authors had no such conflicts. The results were also see favorably more often than in independently financed trials. Furthermore, there was evidence that pharmaceutical companies influenced study protocols in a way that was favorable to themselves.The methodological quality of trials financed by pharmaceutical companies was not found to be any worse than that of trials financed in other ways. Conclusion Published drug trials that are financed by pharmaceutical companies may present a distorted picture. This cannot be explained by any difference in methodological quality between such trials and trials financed in other ways. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). clinical drug trials funded by pharmaceutical companies yield favorable results for the sponsors products more often than independent trials do.This has been demonstrated by a number of studies in recent years Various ways have been described in which pharmaceutical concerns exert influence on the protocol and conduct of drug trials, as well as on the interpretation and publication of their results. Thi s systematic review showed widespread conflicts of interest in the shape of financial connections between scientists, academic institutions, and the pharmaceutical industry. Around one quarter of academic provide and two thirds of academic institutions had financial relationships with industry.Analysis of 8 review articles embracing a total of 1140 original articles (including randomized controlled trials RCT, economic analyses, and retrospective cohort studies) revealed a statistically significant association between funding by biomedical companies and conclusions favorable to the pharmaceutical industry (summarized odds ratio OR 3. 6, 95% confidence interval CI 2. 64. 9). Industry financing was also connected with limitations of publication rights and constraints on access to trial data. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). In the second review, a systematic analysis of 30 publications, Lexchin et al. showed that drug trials financed by pharmaceutical companies are less likely to be published, but that those published more frequently yield positive results for the sponsors products than do independently funded studies (8). The quality of the methods employed (analyzed in 13 publications) in trials financed by pharmaceutical companies was not inferior to that in studies with other sources of funding. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). The authors of the present systematic review set out to assess whether recently published studies reveal a connection between financing of drug trials by pharmaceutical companies and results favorable to these companies products. Part 1 investigates whether and, if so, how the type of funding affects study protocol and quality. Part 2 identifies and depicts the aspects of clinical drug trials that can be influenced by financial support from the pharmaceutical industry. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). The publications included were prim arily studies performed with the expressed goal of comparing clinical trials funded by pharmaceutical companies with clinical trials that had not received financial support from such companies, e. g. , with regard to the results or conclusions. These studies were attended by a number of publications that investigated the consequences of financing of a study by pharmaceutical companies.These included, for example, articles in which information from the files of the US licensing authority (Food and Drug Administration, FDA) was compared with data from publications in medical journals, and case studies on individual substances. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). connectedness between type of funding and results of drug trials Twenty-six of the 57 publications analyzed sought to ascertain whether the results and/or conclusions of drug trials depended on the type of funding or on financial conflicts of interest on the part of the authors (eTable). Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). Altogether, 23 of these 26 studies came to the conclusion that there was a positive correlation between the financing of a study by pharmaceutical companies and/or conflicts of interest on the part of the authors and results or conclusions that were favorable to the sponsor. The statistical significance of this finding was investigated in 22 cases and confirmed in 20. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. ). In 4 cases it was apparent that the findings were interpreted favorably towards the pharmaceutical concern that had funded the study, independent of the results (e5e8). (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). Another study investigated the connection between the conclusions and the source of financial support in clinical trials that had appeared in 5 influential medical journals over a period of 20 years (e10).Most trials yielded positive results for the drug in questio n regardless of the funding source, but this study also revealed a trend over the course of time towards more positive findings in industrially financed trials than in trials supported by non-profit organizations (e10). The third study compared the results (but not the interpretations or conclusions) of clinical trials of drugs used in pain management, some of them long available as generics (e9). (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. ). Five of the 57 studies analyzed investigated whether funding by pharmaceutical companies affected the design of the study protocol (Table 1 gif ppt). The use of placebos was shown to be significantly more common in RCTs of drugs for psoriasis that were financed by such companies than in those with funding from other sources (e12). Moreover, several studies of treatment for previous(p) ejaculation that were sponsored by a pharmaceutical company were found to have disregarded the relevant objective endpoint (e13).In an investi gation of inhaled corticosteroids, significant differences in the frequency of adverse drug reactions (ADR) between the probands and the control group occurred only half as often when the study had been funded by the manufacturers (see also Part 2). The differences could be attributed wholly to the study design. For example, studies financed by pharmaceutical companies used lower dosages. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1).The pharmaceutical company concerned investigated the marketing effect of the study, finding that participating physicians did indeed prescribe rofecoxib significantly more often than non-participants in its first 6 months on the market. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). The results of clinical drug trials that are funded by pharmaceutical companies or whose authors have financial conflicts of interest are favorable to the products of the sponsoring company far more frequently than studies whose fundi ng comes from other sources.Furthermore, interpretation of the data in the conclusions of industrially financed trials more often favors the sponsor. This was shown by the present systematic review and analysis of investigations, published between 1 November 2002 and 16 December 2009, into various diseases, study types (e. g. , RCTs and observational studies), and drugs. The results confirm the conclusions of 2 systematic reviews, both published in 2003, conducted with similar intent (7, 8).The principle of equipoise, i. e. , uncertainty which of the alternative approaches benefits the patient most, forms the ethical foundation of clinical studies in which the probands receive various treatments (14). This principle seems to be violated in many studies funded by pharmaceutical companies. (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). There are numerous reasons why studies financed by pharmaceutical manufacturers more often yield positive results.Four investigatio ns found evidence that pharmaceutical companies influence the study protocol to their advantage (e12e14, e19), e. g. , by more frequent use of placebos in control groups than in independently funded studies (e12). Although the responsible regimen sometimes demand placebo-controlled trials as a condition of licensing, they also request active controls (15). Further factors leading to higher frequency of results favorable to the sponsor in trials funded by pharmaceutical companies are described in Part 2 of this review. Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). Trials financed by pharmaceutical concerns displayed no signs of poorer methodological quality. On the contrary, two studies showed superior quality (e16, e17). It must be taken into account, however, that some factors that serve to assess the quality of the instruments used in a study were not determined, among them the clinical relevance of the target parameters. In oncology, for instance, there are c urrently major defects in the protocols of industrially sponsored clinical trials, e. . , deficiencies in the definition of patient-relevant endpoints and in the selection of suitable substances for the control arm of RCTs (1619). Moreover, clinical trials in oncology are often discontinued after preliminary analysis (20), with the result that only a short time after the licensing of a drug its additional benefits and the safety of new substances can frequently no longer be evaluated, preventing any benefit/risk analysis (21). (Schott, Pachl, Limbach, Gundert-Remy, Ludwig, Lieb, 2011, p. 1). ConclusionWansink argues that the neat challenge in marketing nutrition lies in leveraging new tools of consumer psychology (which he specifically demonstrates) and by applying lessons from other products failures and successes. The same tools and insights that have helped make less nutritious products popular also offer the best opportunity to reintroduce a nutritious lifestyle. The key probl em with marketing nutrition remains, after all, marketing. (Wansink, 2007, p. 1). New services must therefore be oriented toward consumers (i. e. , patients, health professionals, and third-party agencies) to gain acceptance (Grauer, 1981, p. ). We encourage family physicians interested in providing the best care for their patients to become educated in the advertising techniques used by the pharmaceutical industry. (Shaughnessy, Slawson, & Bennett, 1994, p. 1). new challenges as well as opportunities for increasing profitability. If the pharmaceutical companies want to improve their Return-On-Investment (ROI), they have to adopt new communication technologies (digital media) along with their conventional sales force of medical representatives.They really need to adopt this multi channel marketing strategies for the following reasons The concept of blockbuster drugs is dying out for big pharmaceutical companies where 2-3 drugs were good enough to pay back the whole invest ment for a larger number of construct drugs. Now the limited prospective for blockbuster drugs (thanks to low investment on R&D and patent expiry) makes it essential to focus on more specialized drugs sold in lower volumes. And when there is low volume products, sales driven marketing strategy (with high cost of sales force) is not feasible.As far as small pharma companies are concerned, they already have small sales force. However, with the use of digital media, having a lower investment cost (both for the company and its targeted customer) they can easily get return on investment. Customer behavior (doctors behavior) is rapidly changing. Doctors, who are getting more and more busy with increasing patients, can be hardly seen by the medical representatives. They are more inclined towards Internet for obtaining relevant information.It is the time for pharmaceutical companies to build their marketing strategies around this digital media. Website marketing, online marketing, blogs, s ocial media, forums, chat rooms and any other such media is an influential means to present the companys products and offers through opinion leaders (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1). The right marketing strategy for any pharmaceutical company would be to build on be strategic marketing principles, along with a focus on changing customer behavior.Use of digital media through Internet marketing plan is the best marketing strategy that can provide the basis for a changed business model. However, there should be some planning for using digital media for marketing too. It should be a multi channel marketing strategy but should identify the target audience. Every digital media used for all people can not be called the right marketing strategy. The focus should be on the high value customer segment for pharmaceutical products (Need of New Pharmaceutical Marketing Strategies, 2010, p. 1).