How pharma could help itself by helping patients

By guest blogger Daniel Hoffman:

Excesses notwithstanding, the pharmaceutical industry has often done a good job of creating public awareness about important health issues.  Of course, when pharma abuses public awareness campaigns in an effort known as "disease mongering," it obscures those contributions to public health.  As earnings reports for this year's third quarter are now largely concluded, top managers may want to reconsider some benefits to both pharma's image and its sales that can result from the well intentioned sort of awareness campaigns.

In certain quarters, the notion has gained currency that any pharma effort to increase public knowledge about a particular illness or condition represents a cynical bit of deceptive promotion.  Granted, there are many cases to fuel such cynicism, including those involving Social Anxiety Disorder, Overactive Bladder and, a favorite, Female Hypoactive Sexual Desire Disorder.  Pharma in those instances merely borrowed a technique from its patent medicine cousins who demonstrated in the early 20th century that stigmatizing bad breath, perspiration stains and yellow teeth can expand revenue.

At the same time pharma has also met the expectations of people who expect more from its public campaigns than they do from snake oil salesmen.  In 1987, for example, Merck launched Mevacor and inaugurated an entirely new approach to lowering cholesterol levels.  Coinciding with that launch, the company joined cereal maker Kellogg in sponsoring a campaign to raise public awareness about the importance of controlling cholesterol.  Epidemiologists found that 30% of heart attacks and strokes are due to high cholesterol, so Merck's public education effort served a useful purpose while, at the same time, it helped make cholesterol drugs the world's top-selling therapeutic class.

High blood pressure is an even bigger cause of heart attacks and strokes.  Starting in the 1980s, many pharmaceutical companies used public education campaigns to help promote their respective medications for lowering blood pressure.  Their campaigns played a useful role that contributed to both greater public awareness of blood pressure and to its overall improvement.  This month, for example, the Centers for Disease Control and Prevention found that the percentage of people who know they have high blood pressure has increased from 69.6% in 1999-2000 to 80.6% in 2007-2008.  Armed with more knowledge, the percentage of people with high blood pressure that took medications for it increased from 60.2% to 73.7% during that period, while the percentage of people who have been able to control their blood pressure also increased among all population subgroups.
Some pharma companies such as Eli Lilly, Sanofi-Aventis and Novo Nordisk have recently started campaigns to stress the importance of weight control as a major factor for preventing and slowing diabetes.  Lilly, for example, is a major sponsor of Michelle Obama's campaign against juvenile obesity.

A number of us believe pharma companies should follow up these constructive types of public campaigns by working with medical practices to create patient service programs that offer the kind of detailed education and frequent contact physicians cannot provide.  Granted, such programs are costly and their connection to increased sales of any particular product must be determined in each case, but when they work, everyone benefits.  Insurers' costs go down and some of them are starting to share those cost savings with the responsible medical practices.  More importantly, as the recent CDC report shows, the public can benefit and that ultimately helps pharma too.

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