Big Pharma (The Play)

A nyone who has experienced the assault of the pharmaceutical industry's marketing campaigns would appreciate Jennifer Berry's one-person play Big Pharma: The Rise of the Anti-Depressant Drug Industry and the Loss of a Generation. Since the mid-1990s, spending on drug promotion has grown steadily, reaching $21 billion in 2002. Berry explores the fallout of this expanded marketing blitz through the eyes of its masterminds, unwitting (and complicit) abettors, and victims through her portrayal of an advertising executive, a physician, and women and children who are prescribed heavily marketed antidepressants. A primary target of the pharmaceutical industry, physicians receive not just advertising materials but offi ce visits from drug representatives. Berry's physician, depicted as a pawn of the pharmaceutical industry, gratefully accepts the free drug samples, the free lunches, and the pharmaceutical industry–sponsored trips to tropical islands. In fact, the pharmaceutical industry woos physicians with educational dinners, honoraria for participating in conference calls, consulting fees for participating in speakers' bureaus, research funding, and payments to write scientifi c publications. And physicians act as agents of the pharmaceutical industry in many ways, such as giving talks that favor a company's product, participating in clinical trials that increase physicians' exposure to a new drugs or new indications for old drugs, and publishing research articles that are fi nanced and, in fact, written by pharmaceutical company employees [1]. In addition to reaching physicians directly, the industry promotes consumer familiarity with particular drugs. In 2002, almost $3 billion of the industry's drug promotion budget was spent on direct-to-consumer advertising [2], with advertising venues spanning from print media to radio, television, and the Internet [3]. In her play, Berry notes that direct-to-consumer drug advertising skyrocketed in the United States after a 1997 change in the Food and Drug Administration guidelines for advertising. She also gives a nod to the nearly incomprehensible patient information that must be provided with each ad: " We tell them to buy it, then tell them why not to buy it. " And, the " why not " is presented in an illegible font in print ads, or high-speed chatter for television and radio. Less obvious marketing strategies include using opinion leaders, and sponsoring education programs, scientifi c research, publications, and professional meetings. The pharmaceutical industry has also extended its infl uence to clinical trial administration, research design, regulatory lobbying, physician and patient education, drug pricing, pharmacy distribution, and drug compliance [4]. …