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Big Pharma’s Enclosure of Academic Medicine


“What I didn’t realize was how thoroughly drug marketers have corrupted academic medicine — the research at medical centers, the education of new doctors at medical schools, and daily clinical practice. In the May-June issue of the Boston Review, Marcia Angell, the former Editor of the New England Journal of Medicine, documents in devastating detail how the drug industry has insinuated itself into every imaginable nook and cranny of academic medicine in order to sell its drugs.

The best indication of its success is the invisibility of the marketing. The sales propaganda has gotten so effective that it is brilliantly disguised as high-minded “education.” Marketing has become a normative part of medical education, research and practice.”

“…the steady accretion of facts makes a powerful case that academic medicine has willingly surrendered its integrity and independence to the drug industry — with troubling consequences for the safety and scientific merit of many drugs and types of medical treatment.

Angell notes how medical centers and med schools have joined hands with the drug industry at numerous points — in striking up research partnerships, in sitting on companies’ boards of directors, in offering up clinical facilities for drug trials, in sitting on advisory boards.

These incestuous relationships not only affect how research is shaped — what questions are asked and how research projects are designed and published; they also affect how medicine is practiced. Academics with paid ties to the industry play influential roles in writing practice guidelines that professional and governmental bodies issue, and they participate in numerous FDA deliberations.”

“One respondent, Adriane Fugh-Berman, elaborates in great detail how continuing medical education courses serve as a prime channel for pharmaceutical marketing:

Industry-paid speakers frequently deny espousing marketing messages. I’ve heard many physicians justify their pharma-funded speaking gigs by saying, “I never emphasize their product” or, triumphantly, “I don’t even mention their drug!” But these comments only highlight their sales skills. Pharma doesn’t hire doctors to sell drugs; that’s a drug rep’s job. Pharma hires physicians to sell diseases.

The process of selling what industry calls a disease state begins many years before a drug is submitted to the FDA for approval. Specific marketing messages for a product may be developed seven to ten years before a drug goes on sale.”