Tuesday, August 30, 2005

Ethical Pharma Marketing: Oxymoronic?

The Industry Veteran (a pseudonym) over at The Health Care Blog yesterday wrote a piece that criticized pharmaceutical marketing and concluded that "Pharma has switched from a research-driven industry to one that is driven by bad and unethical marketing." (see "The Industry Veteran, on what the Vioxx verdict means," posted 8/29/2005).

This leads me to ask, can ethics can be applied to marketing in general and pharmaceutical marketing in particular? I ask this because the public generally accepts that marketing "stretches the truth" and needs to be taken with a grain of salt as it were. In fact, marketers have been called "bullshit artists" more or less as a term of endearment or at least one that signals tolerance. I discussed the "bullshit" nature of marketing before and even invented the "bullshit meter" to measure the level of bullshit in pharmaceutical marketing. See "Is Pharmaceutical Marketing a Lot of BS?" for more on this subject.

In the book "All Marketers Are Liars" the author, Seth Godin, makes this case: "Successful marketers are just the providers of stories that consumers choose to believe. ...the only way your idea will spread is if your tell the truth. And you are telling the truth when you live the story you are telling--when it's
authentic. This is what makes it all work: a complete dedication to and embrace of your story."

For Godin and many other marketers "truth" becomes "a complete dedication to and embrace of your story." This is the essence of a bullshitter. A bullshitter has no regard for what is literally true and cannot possibly "prove" his claims based on evidence. This is why Merck lost its first Vioxx trial -- the evidence was irrelevant because the marketers told consumers a story they wanted to believe: Vioxx worked and was safe (even Dorothy Hamill used it; would we hurt Dorothy?).

Ethics involves more than telling the truth or being authentic. "Truthful" or "authentic" marketing communications can be unethical. Advertising never "tells the truth, the whole truth, and nothing but the truth" as required by testimony before a court of law. Marketers can tell only part of the truth; i.e., dodge side effect issues revealed only at higher than recommended doses for a drug ("Doctor, there are no proven cardiovascular side effects at the 20 mg dosage level."). And even though there are laws and regulations governing pharmaceutical and other forms of advertising, unethical advertising can be completely legal.

Ethics is about making tough decisions based upon a person's moral principles and values. These decisions are not made in a vacuum. When you work for a large public company that puts pressure on its managers to "make the numbers," it's difficult to do the right thing unless there is strong support from the top down. That top-down support seemed to be missing at Merck, which has lost its venerable moral compass
(see Corporate "Moral Values" Anyone?).

The answer to the question I put at the beginning is "yes," we can apply ethics to pharmaceutical marketing and "ethical pharmaceutical marketing" is not oxymoronic! You can't, however, expect marketing managers to lead the way. This is a job for the CEO and top management.

I suggest that pharma companies can win a lot more public trust by dusting off their corporate codes of ethics -- I'm not talking about the new DTC advertising principles, which were designed more for public relations than for defining ethical behavior -- and clearly defining where the limits are for employees. If you don't already have one, create a corporate ethics officer that reports directly to the CEO. And, please, do NOT give this job to a lawyer! (Only one in five corporations have an ethics officer.) Top management should make it clear that they live by the code and expect the same from all employees.

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