I am in the process of reading a book review. The book is “
Selling Sickness” by Alan Cassels and Ray Moynihan. It was only about a couple of sentences into the review when I started to become outraged. What I was reading was not news to me, it simply reawakened the ever-present awareness about the monster that lives in our country—Pharmaceutical companies.
I am going to quote the authors on what I find is very interesting and what the public should be made aware of.
“Thirty years ago the head of one of the world’s best-known drug companies, Merck, made some over-candid comments. The aggressive chief executive, Henry Gadsden, who was close to retirement at the time, told Fortune magazine of his distress that Merck’s potential markets had been limited to sick people; he said he would have preferred Merck to be more like the chewing-gum manufacturer Wrigley, because then Merck would be able to “sell to everyone”; it had long been his dream to make drugs for healthy people. His dream has since come true.
“The marketing strategies of the world’s biggest drug companies now aggressively target the healthy. The ups and downs of daily life have become classified as mental disorders, common complaints are transformed into frightening conditions, and more and more people are turned into patients. The $500 billion pharmaceutical industry is changing what it means to be human, with promotional campaigns that exploit our deepest fears of death, decay and disease. Rightly rewarded for saving life and reducing suffering, the global drug giants are no longer content with selling medicines only to the ill. As Wall Street knows well, there is a lot of money to be made telling healthy people that they’re sick…
The epicenter of this selling is the United States, home to many of the world’s largest pharmaceutical companies. The US has less than 5% of the world’s population but represents almost 50% of the global market in prescription drugs. Pharmaceuticals spending in the US continues to rise more rapidly than anywhere else, increasing by almost 100% in just six years, not only because of steep increases in the price of drugs, but because doctors prescribe more and more of them.”
The authors go on to mention Vince Perry’s publication ”The Art of Branding a Condition.” Vince Parry is “an expert in advertising who works from his mid-town Manhattan office in New York, Parry specializes in the most sophisticated form of medicine salesmanship: he works with drug companies to help create new diseases.
In an astonishing publication, The Art of Branding a Condition, he recently revealed the ways in which companies are involved in fostering the creation of medical disorders. Sometimes a little-known condition gets fresh attention, sometimes an old disease is redefined and renamed, and sometimes a whole new dysfunction is created. Parry’s personal favorites include erectile dysfunction, adult attention deficit disorder, and pre-menstrual dysphoric disorder (which is so controversial a classification that some researchers say it doesn’t exist).”
I was curious enough to start searching for the publication. I could not find the entire document available on-line, however, I did find enough to get me going for a couple of months.
Rather than tell you what Vince Parry wrote in his publication, I will instead quote from it—it is better to get the news straight from the horse’s mouth, it’s been said.
“Branding is about the ownership of ideas: giving customers a new way to think about things, and - in the process - transferring the values of this experience to a situation or commodity.
… within the pharmaceutical industry, marketing professionals have increasingly taken branding to the next level by branding the disease or condition that a particular product is capable of treating.
The idea behind "condition branding" is relatively simple: If you can define a particular condition and its associated symptoms in the minds of physicians and patients, you can also predicate the best treatment for that condition.
This concept is by no means new. Warner-Lambert was looking for an opportunity to expand its market for Listerine in the 1920s. Although the product was being marketed for everything from dandruff to wound irrigation, sales were flat. Warner-Lambert found its answer by creating awareness - and anxiety - around a serious-sounding medical condition: halitosis. Whereas the harmless concept of unpleasant breath would not cause much of a stir, halitosis - through effective branding or the ownership of ideas - was demonized for a range of social casualties from lack of career advancement to divorce. As the antidote, Listerine saw sales increase from $100,000 to $4 million over the next six years, and helped make halitosis a household word.
If done appropriately, condition branding has numerous benefits, the greatest of which is how it creates consensus internally and externally. Such consensus serves to keep brand managers and the clinical community focused on a single story with a lock-and-key, problem/solution structure. Internally, the activity fosters motivation and momentum, maximizing the product investment by initiating comprehensive marketing efforts early in the process. The product can better own customer perceptions about evolving/existing disease states, define new patient segments with currently unmet needs and drive attitudes about new scientific modalities that promise greater treatment benefits.
Externally, the value of company-sponsored activity helps forge better relationships with thought leaders seeking to shape the debate around therapeutic approaches, and with members of the clinical community who are always interested in mentoring patients on new perspectives in treatment.
There are three principal strategies for fostering the creation of a condition and aligning it with a product:
* elevating the importance of an existing condition
* redefining an existing condition to reduce a stigma
* developing a new condition to build recognition for an unmet market need.
In 1986, GlaxoSmithKline successfully launched Zantac for ulcers, but it faced the challenge of broadening its reach into the heartburn market. Heartburn, after all, did not seem to warrant a prescription drug and was perceived to be well managed by over-the-counter remedies. GERD elevated the medical importance of the condition by presenting it as an acutely chronic "disorder" with an underlying physiologic etiology and the potential for serious longer-term consequences if left unresolved - a far cry from the "plop-plop, fizz-fizz" perception of heartburn.
The company launched a well-coordinated initiative by creating the Glaxo Institute for Digestive Health (GIDH), which served as a platform for education and awareness. The GIDH sponsored research awards in the area of GI health, discussed GERD in the context of other, more serious gastrointestinal (GI) diseases, involved powerful third-party advocates such as the American College of Gastroenterology and fielded a public relations effort called Heartburn Across America. Not only did GSK double the percentage of physicians who perceived them as leaders in GI health, but it helped them drive annual sales for Zantac to over $2 billion at peak, 65 percent of which was accounted for by GERD.
Perhaps the most well-recognized example today of a company redefining an existing condition to reduce stigma is Pfizer and its successful effort to link erectile dysfunction, or ED, with the drug Viagra (sildenafil citrate). Impotence has long existed as a recognized medical condition, but it was associated either with disability linked to physical trauma, or more commonly, with a loss of libido - both of which contribute to low self-esteem in a patriarchal society. Furthermore, the remedies over the years were often invasive and their implementation indiscreet. The term "erectile dysfunction" refocused the condition from being associated with a lack of potency (i.e. male virility) to the more enlightened concept of a physical loss of function that could be simply reversed. Like GERD, ED was captured in an acronym suitable for mass DTC promotion and functioned as an easy password between physician and patient to initiate a formerly difficult conversation. Furthermore, the brand personality of ED - simple, discreet and empowering - aligned beautifully with that of Viagra, an elegant and effective solution to this redefined condition.
No therapeutic category is more accepting of condition branding than the field of anxiety and depression, where illness is rarely based on measurable physical symptoms and, therefore, open to conceptual definition. Watching the Diagnostic and Statistical Manual of Mental Disorders (DSM) balloon in size over the decades to its current phonebook dimensions would have us believe that the world is a more unstable place today than ever. In reality, the increasing number of identified emotional conditions has resulted from breaking the problems into their component parts to better assess treatment options. Not surprisingly, many of these newly coined conditions were brought to light through direct funding by pharmaceutical companies, in research, in publicity or both.
A legendary example of this condition branding strategy was the development of Xanax (alprazolam) for panic disorder in the 1970s… Upjohn, the makers of Xanax, helped fund this early research, as well as publications and speaking tours to cardiologists to help raise awareness of the heart-brain connection in the minds of panic disorder patients… Xanax was the first to receive an exclusive indication, thereby maintaining its leadership in anxiety disorders. Since the release of DSM-III in 1980, which first recognized panic disorder as a distinct condition, its incidence has grown 1,000-fold, and newer antide-pressants have stepped in to foster expanding ideas about panic.
A recent example is the recognition of premenstrual dysphoric disorder (PMDD) in DSM-IV and the subsequent indication for Sarafem (fluoxetine hydrochloride). PMDD is a severe form of premenstrual syndrome, or PMS.
As many industry insiders know, Sarafem is identical in formula and dose to Prozac (marketed at the time by Lilly), so the branding strategy that helped build awareness for both the condition and the drug were fascinatingly integrated. A company-sponsored prelaunch initiative built awareness for the new condition, recasting diagnosis to conform to the new criteria. While the condition effectively captured the branded concept of unwellness associated with hormonal transition, the remedy (Prozac) evoked conflicting notions of a mental disorder. By changing the brand name from Prozac to Sarafem - packaged in a lavender-colored pill and promoted with images of sunflowers and smart women - Lilly created a brand that better aligned with the personality of the condition for a hand-in-glove fit.”
This is only a small portion of the publication. The author goes on to give an advise on how to make the “product” (medical drugs) more marketable and to own the market by following certain steps.
Amazing? No, I would rather say that it is appalling. Ridiculous indeed. Yet the public is blindly following the “industry leaders” into leading drug-induced lives, rather than solving physical problems with a whole-foods diet and exercise.
Until next time, folks, remember:
EAT HEALTHY!!! LIVE HAPPY!!! 
The extra time off allowed me to finally sit down and find a worthy upgrade to my dinosaurish PC—I have ordered a new Dell XPS 435 with a 24” monitor, which will be arriving this week! I am SOOOOOOO thrilled! A good computer is very much a necessity in my house: I do not only blog about food and nutrition, but I am also a photographer [Longview and Kelso, WA Photographer], so my livelihood depends on the speed of my technology. I have also recently taken on another blogging task—blogging for my church—Kelso Church of Truth, WA. [So much for taking time off ;) but that is what normally happens to me.]
The extra time off allowed me to finally sit down and find a worthy upgrade to my dinosaurish PC—I have ordered a new Dell XPS 435 with a 24” monitor, which will be arriving this week! I am SOOOOOOO thrilled! A good computer is very much a necessity in my house: I do not only blog about food and nutrition, but I am also a photographer [Longview and Kelso, WA Photographer], so my livelihood depends on the speed of my technology. I have also recently taken on another blogging task—blogging for my church—Kelso Church of Truth, WA. [So much for taking time off ;) but that is what normally happens to me.]
