Hand In Glove
Amidst the skeptical cloud of indecisiveness and authenticity, the field of pharmaceutical advertising had completed nearly three centuries of successful drug endorsing but the usefulness and verity of drug promotion has always been a controversial topic for many years. False or misleading claims; disregarding of adverse effects and other data that are important for prescription have been largely subjected to medical criticism. 1
Despite the criticism, the key driving force behind a successful launch of pharmaceutical products worldwide has always been pharmaceutical advertising. It has been strongly evidenced that the field of pharmaceutical advertising is the prime source of public health information (which varies according to the respective state’s law) exerting a significant influence on consumers’ product choice as well as changing the prescription pattern of the physician.2
It is interesting to note that although the birth of medical advertising and its criticism began within the same century, it was hardly within the same continent.
The Dream Ticket
One of the earliest recorded medical advertisements were the testimonials given by the solicited or otherwise treated patients in newspapers. The following is an excerpt from an English newspaper, The Daily Post from 14th July 1736
“These are to certify that I, Richard Sandford, waterman, dwelling in Horselydown Street near the Dipping Pond have a son . . . who for long had been suffering from debility, pains in the stomach and general malaise when he had recollected that his wife’s mother had had “a palsy or hemiplegia” of which she had been cured by Mr John Moore, Apothecary, At the Pestle and Mortar in Laurence Pountney’s Lane, the first Great Gates on the Left-Hand from Cannon Street.
I applied to him for relief for my son, who after taking a few Worm Powders brought forth a WORM (or INSECT) like a Hog-Louse with Legs and hairy, or a kind of Down all over it, and very probably more but he going to a common Vault they were lost, upon which he is amended.
– 3 October, 1735”3
The above advertisement is one of many such testimonials printed in newspapers given by supposedly treated patients. Devoid of both – an overseeing regulatory authority for pharmaceutical advertising as well as a peer review of the medicine, the quacks enjoyed their heydays with their nostrums.
Pressing The Right Buttons
Thomas Holloway (1748-1827) amassed a fortune from patenting his medicines, by the explicit usage of newspapers for both advertisings as well as a vehicle for new stories of astounding cures. One of his famous slogans is, “Take Holloway’s Pills; apply Holloway’s Ointment” The pills which contained aloes, powdered ginger, and soap were supposed to cleanse “the system and putting the liver and kidneys in functional order without pain or griping.” Nevertheless, the extravagant profits from Holloway’s Pills were blatantly disproportionate to their supposedly claimed therapeutic performance.4
Angelo Mariani, in 1863 introduced Vin Mariani, a glass of wine into the market which contained ethanol and cocaine – creating cocaethylene. This synergistic compound was popularized by a depressed actress who experienced its spectacular results first hand.5 Rather than his invention of the drink, Mariani is more remembered for his marketing strategy. In the words of William Helfand (an authority on the history of medical quackery ), he was “a genius at promotion and at projecting and keeping the name of his product in the public eye . . . The key element in his marketing strategy was the testimonial”. Mariani developed with remarkable success the use of “. . . important members of society, people in the establishment, opinion ” leaders and influentials . . . in contrast to the usual procedure of having an average.” Thomas Edison is one of such internationally known figures who substantiated Mariani’s claims.3
Set The Ball Rolling
The year 1881 witnessed the strongest antiquackery law come into effect in the state of rapidly industrializing West Virginia. Dr. James Reeves who served as the 1st Secretary of Medical Society of West Virginia was the driving force behind the act which was intended to “establish the hegemony of regular, scientifically trained physicians over other health practitioners (i.e., quacks)”.6
By 1905 the American Medical Association (AMA) established the Council on Pharmacy and Chemistry (CPC) which set the standards for evaluating “ethical drugs”, thus encouraging the commoners in the usage of drugs prepared and prescribed by physicians as well as discouraging the prescription and sale of nostrums by quacks. Both laws created ripples of awareness in the ignoramus of the laissez-faire society.7
Also, self-medication was regarded as a threat to the medical profession by the AMA and to hinder the process, it created an incentive for pharmaceutical companies to concentrate their advertising acumen on physicians.8
The creation of CPC enabled the makers of “ethical drugs” to focus on making promotional materials for physicians rather than consumers. This paved the foundation of establishing rudimentary but proper medical communications.7
Since then it has been a long way and medical communications have crossed several milestones. It has grown up, refraining from unnecessary claims of absurd treatment to delivering a critically analyzed article to the health care personnel. An estimated 84% of pharmaceutical marketing efforts are directed toward physicians as they are the gatekeepers to the drug sales.9
- Martínez PV, et al. Accuracy of pharmaceutical advertisements in medical journals. The Lancet. 2003; 361(9351):27-32
- Paek JH, et al. Pharmaceutical Advertising in Korea, Japan, Hong Kong, Australia, and the US: Current Conditions and Future Directions. Health Communication Research. 2011; 3(1):1-63
- Burnby J. Pharmaceutical Advertisement in the 17th and 18th Centuries. European Journal of Marketing. 1988;22(4):24-40.
- Ferner R. A short history of pharmaceutical marketing. BMJ 2012;345:e7801
- Available at: https://www.independent.co.uk/news/uk/this-britain/drug-that-spans-the-ages-the-history-of-cocaine-6107930.htmlAccessed on: 18 October, 2020
- Harris Jr JM. Medical Ethics, Methodism, and a Nineteenth-Century West Virginian’s Battles with Quackery. West Virginia History: A Journal of Regional Studies. 2016; 10(7): 27-44
- Available at: https://prescriptiondrugs.procon.org/history-of-prescription-drug-ads/Accessed on: 18 October, 2020
- Donohue J. A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection. Milbank Q. 2006; 84(4): 659–699.
- Khazzaka M. Pharmaceutical marketing strategies’ influence on physicians’ prescribing pattern in Lebanon: ethics, gifts, and samples. BMC Health Services Research. 2019; 19(80)