Abstract
This chapter discusses some strategies pharmaceutical companies employ to establish influence and even hegemony over domains of medical knowledge: marketing products via medical research and education. The chapter thus contributes to understanding the political economy of knowledge in this industry. As a counterpart to traditional epistemology, studying the political economy of knowledge shifts attention from individual claims and their justifications to some of the forces available to shape terrains on which claims are produced, distributed, and consumed.
Of pharmaceutical companies’ clinical research, 70–75% is performed by contract research organizations (CROs). CROs conduct trials with one eye to the drug approval process and the other to the marketing of products. On the basis of trial data, analyzed by pharmaceutical company statisticians and scientists, publication planners design suites of scientific manuscripts and hire ghostwriters to write them. These are then given to academic authors, who generally have had little prior connection to the research, analysis, or writing. The manuscripts are published in medical journals appropriate for the audiences the companies wish to reach.
The doctors and researchers with whom companies engage most closely are generally termed key opinion leaders (KOLs). In addition to authoring manuscripts, KOLs serve companies in a number of roles, but most prominently as speakers—at professional meetings, in after-dinner and similar settings arranged by sales representatives, and in continuing medical education (CME) courses, which doctors must take to keep their licenses. Research, education, and marketing, then, are often fused.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Accreditation Council for Continuing Medical Education. 2012. Annual Report. http://www.accme.org/sites/default/files/630_2012_Annual_Report_20130724_1.pdf . Accessed 3 Oct 2013.
Adis Communications. 2006. http://www.pharmalive.com/content/supplements/gpms/2004/adis.cfm . Accessed 20 Dec 2006.
Angell, M. 2004. The Rruth about the Drug companies: How They Deceive Us and What to Do about It. New York: Random House.
Applbaum, K. 2004. The Marketing Era: From Professional Practice to Global Provisioning. New York: Routledge.
Bohdanowicz, H. 2005, September 21. A Guide to Strategic Communication Planning. Pharmaceutical Executive Europe.
———. 2009. The Synergy of Public Relations and Medical Education. Communiqué 24: 14–16.
Brody, H. 2007. Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry. Lanham: Rowman & Littlefield Publishers.
CampbellAlliance. 2011 Communicating the Value of Medical Affairs. Brochure for a Whitepaper.
Carlat, D. 2007, Nov. 25. Dr. Drug Rep. The New York Times.
CenterWatch. 2009. State of the Clinical Trials Industry: A Sourcebook of Charts and Statistics. Boston: CenterWatch.
Envision Pharma. 2006. http://www.envisionpharma.com/publicationsPlanning/. Accessed 20 Dec 2006.
Fisher, J. 2009. Medical Research for Hire: The Political Economy of Pharmaceutical Clinical Trials. New Brunswick: Rutgers University Press.
Fugh-Berman, A., and S. Ahari. 2007. Following the Script: How Drug Reps Make Friends and Influence Doctors. PLoS Medicine 4(4): e150.
Gardiner-Caldwell Group. 2007. http://www.thgc-group.com/. Accessed Nov 2007.
Gramsci, A. 1971 Selections from the Prison Notebooks of Antonio Gramsci, Eds. and trans. Q. Hoare and G.N. Smith. New York: International.
Healy, D., and D. Cattell. 2003. Interface between Authorship, Industry and Science in the Domain of Therapeutics. The British Journal of Psychiatry 183: 22–27.
Hensley, S., and B. Martinez. 2005, July 15. New Treatment: To Sell Their Drugs, Companies Increasingly Rely on Doctors. Wall Street Journal.
ICMJE. 2014. Defining the Role of Authors and Contributors. http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html . Accessed 30 Jan 2015.
InsiteResearch. 2008. The Prescription for KOL Management. Next Generation Pharmaceutical 12. http://www.ngpharma.com/. Accessed 28 Mar 2011.
Katz, E., and P. Lazarsfeld. 1955. Personal Influence: The Part Played by People in the Flow of Mass Communications. Glencoe: The Free Press.
KnowledgePoint360. 2010. Promotional Brochure.
Lundh, A., S. Sismondo, J. Lexchin, O. Busuioc, and L. Bero. 2012. Industry Sponsorship and Research Outcome. Cochrane Database of Systematic Reviews 12: MR000033.
Mirowski, P., and R. Van Horn. 2005. The Contract Research Organization and the Commercialization of Scientific Research. Social Studies of Science 35: 503–534.
Moynihan, R. 2008. Key Opinion Leaders: Independent Experts or Drug Representatives in Disguise. British Medical Journal 336: 1402–1403.
Oldani, M. 2004. Thick Prescriptions: Toward an Interpretation of Pharmaceutical Sales Practices. Medical Anthropology Quarterly 18(3): 325–356.
Petryna, A. 2009. When Experiments Travel: Clinical Trials and the Global Search for Human Subjects. Princeton: Princeton University Press.
Reid, L., and M. Herder. 2013. The Speakers’ Bureau System: A Form of Peer Selling. Open Medicine 7(2): e31.
Ross, J.S., K.P. Hill, D.S. Egilman, and H.M. Krumholz. 2008. Guest Authorship and Ghostwriting in Publications Related to Rofecoxib: A Case Study of Industry Documents from Rofecoxib Litigation. Journal of the American Medical Association 299(15): 1800–1812.
Shah, S. 2006. The Body Hunters: Testing New Drugs on the World’s Poorest Patients. New York: New Press.
Sismondo, S. 2007. Ghost Management: How Much of the Medical Literature is Shaped Behind the Scenes by the Pharmaceutical Industry? PLoS Medicine 4(9): e286.
———. 2009. Ghosts in the Machine: Publication Planning in the Medical Sciences. Social Studies of Science 39(2): 171–198.
Smith, R. 2006. Lapses at the New England Journal of Medicine. Journal of the Royal Society of Medicine 99(8): 380–382.
Watermeadow Medical. 2007. http://www.watermeadowmedical.com/. Accessed 29 Nov 2007.
Wave Healthcare. 2011. KOL Training. http://www.wavehealthcare.co.uk/en/1/koltraining.html. Accessed 25 Mar 2011.
Wyeth. 2002. Publication Plan 2002—Premarin/Trimegestone HRT Working Draft. http://dida.library.ucsf.edu/tid/awb37b10. Accessed 19 Aug 2013.
Acknowledgment
This chapter presents material from a large project on the political economy of pharmaceutical knowledge. That project was funded by a grant from the Social Sciences and Humanities Research Council of Canada (#410-2010-1033). Some additional research was funded by a grant from the Canadian Institutes of Health Research (#2009-11-02). Zdenka Chloubova performed many of the interviews quoted here. Khadija Coxon assisted with other research that made its way into this chapter and helped considerably with the organization of a draft. Apologies are owed to Ernesto Laclau and Chantal Mouffe for the chapter’s title.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Sismondo, S. (2017). Hegemony of Knowledge and Pharmaceutical Industry Strategy. In: Ho, D. (eds) Philosophical Issues in Pharmaceutics. Philosophy and Medicine, vol 122. Springer, Dordrecht. https://doi.org/10.1007/978-94-024-0979-6_4
Download citation
DOI: https://doi.org/10.1007/978-94-024-0979-6_4
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-024-0977-2
Online ISBN: 978-94-024-0979-6
eBook Packages: Religion and PhilosophyPhilosophy and Religion (R0)