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From Evidence-based Medicine to Marketing-based Medicine: Evidence from Internal Industry Documents


While much excitement has been generated surrounding evidence-based medicine, internal documents from the pharmaceutical industry suggest that the publicly available evidence base may not accurately represent the underlying data regarding its products. The industry and its associated medical communication firms state that publications in the medical literature primarily serve marketing interests. Suppression and spinning of negative data and ghostwriting have emerged as tools to help manage medical journal publications to best suit product sales, while disease mongering and market segmentation of physicians are also used to efficiently maximize profits. We propose that while evidence-based medicine is a noble ideal, marketing-based medicine is the current reality.

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  1. One of the authors (PP) prescribed quetiapine to several patients due to its promotion as weight-neutral (based on publicly available EBM at the time) and was quite surprised when some patients experienced significant weight gain.


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The authors wish to acknowledge the work of journalist, Philip Dawdy, who has written much on these documents and whose website is one of the main hosts of internal industry documents. We also recognize the work of journalist Jim Edwards (, who has written much about several of the documents discussed in this paper.


Glen I. Spielmans has holdings of less than $10,000 in a mutual fund (Vanguard Health Care), which invests nearly exclusively in pharmaceutical companies. Dr.Parry is a member of Healthy Skepticism.

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Correspondence to Glen I. Spielmans.

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Spielmans, G.I., Parry, P.I. From Evidence-based Medicine to Marketing-based Medicine: Evidence from Internal Industry Documents. Bioethical Inquiry 7, 13–29 (2010).

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  • Evidence-based medicine
  • Marketing
  • Marketing-based medicine
  • Pharmaceutical industry
  • Olanzapine
  • Quetiapine