This review of recently published pharmaceutical industry-sponsored comparative psychotropic drug trials aims to classify apparent design and reporting modifications that favor the sponsor's product. The modifications have been grouped into 13 discrete categories, and representative examples of each are presented. Strong circumstantial evidence suggests that marketing goals led to these adjustm...

the state and federal governments that pay much of the cost of prescription drugs for their employees and for the poor or uninsured. An alternative to this model is to have physicians, relying on their training and experience, peer-reviewed journa l articles, and non-industry-sponsored continuing medical education, determine what medications are appropriate for their patients. Elliott argues th...

BUMC PROCEEDINGS 2003;16:359–361 Over the past 13 years, one constant in the field of health care liability claims has been litigation over medical devices and products. The 1990s began with the silicone gel breast implant litigation. The balance of the 1990s was devoted to litigation on Norplant and the diet drug combination fenfluramine-phentermine (fen-phen); these cases are still ongoing. T...

I t is often said that leading drug companies now spend more on marketing than on research and development [1]. While such contemporary pharmaceutical marketing practices are sometimes believed to be a modern phenomenon, they are in fact a direct continuation of 19th-century patent medicine advertising. " Nostrum-mongers, " as the novelist Henry James dubbed them, are noted in the history of ad...

A sharply dressed, attractive female walks into the waiting room of an office. All eyes turn and look at this young lady, who looks quite out of place amongst the throngs of elderly, young, and sick patients waiting long periods to see their doctor. This person, carrying meals, gifts, and free drugs, skips the line of patients waiting to be seen and walks right into the back, embracing a friend...

The Black Swan, a metaphor for highly improbable, high impact events, warns us to understand the limits of our predictions and expect the “unknown unknowns” everywhere, from war to science and industry. From the earliest stages of discovery to post-marketing events, we argue that fundamentally the structure of pharmaceutical industry is driven by and impacted by both positive and negative Black...

Marketing costs exceed 30% of revenues for the pharmaceutical industry, with over 90% of the effort aimed at physicians. Although there are currently unprecedented numbers of regulatory activities focusing on relationships between the pharmaceutical industry and the medical profession, such legislation is often unrecognized or flouted. The potential influence, although minimized by both parties...