Pharmaceutical Marketing and the Invention of the Medical Consumer

Abstract:  It is often said that leading drug companies now spend more on marketing than on research and development. While such contemporary pharmaceutical marketing practices are sometimes believed to be a modern phenomenon, they are in fact a direct continuation of 19th-century patent medicine advertising. "Nostrum-mongers," as the novelist Henry James dubbed them, are noted in the history of advertising as having been the leading spenders on, and foremost originators of, advertising technique. Nostrum sellers pioneered print advertising, use of trademarks and distinctive packaging, “pull” or demand-stimulation strategies, and even the design and commissioning of medical almanacs that functioned as vehicles for promotion of disease awareness. Henry James's psychologist brother, William James, was so exasperated by “the medical advertisement abomination” that in 1894 he declared that “the authors of these advertisements should be treated as public enemies and have no mercy shown”. There is no doubt that drug company discoveries have profoundly improved upon our capacity to treat illness. But pharmaceutical marketing is more closely aligned with consumer marketing in other industries than with medicine, for which the consequences are not trivial. Once we view pharmaceutical industry activities in this light, we can disentangle industry's influence on contemporary medicine. Because we believe that we owe corporations our wealth and well-being, we tend not to question corporations' fundamental practices, and they become invisible to us. What follows is an attempt to demystify some of the assumptions at work in the “culture of marketing,” toward the goal of explaining contemporary disease mongering. Citati on: Applbaum K (2006) Pharmaceutical Marketing and the Invention of the Medical Consumer. PLoS Med 3(4): e189. doi:10.1371/journal. pmed.0030189