But is the pharmaceutical industry primarily driven by innovation or by marketing? An age-old question which has not yet been given an unequivocal answer, even if the controversies on excessive spending on marketing, particularly in the United States, resurface periodically. After all, it is a fact that the most advertised drugs are the ones most frequently prescribed.
But even in Italy there has been controversy, so much so that a document of the Italian Medicines Agency (AIFA) in 2004 supported the need to overcome the asymmetry of a system which today sees in our country a higher number of scientific representatives than to other European countries, and therefore an imbalance between promotion and research. And the pharmaceutical companies have taken note of it, given that in 2007, according to Il Sole 24 Ore, there were at least 2,000 informants sold by pharmaceutical companies to container companies, over 5,000 in five years. With the aim of reaching cuts for ten thousand units, in practice one scientific representative out of three to be sold. A change aimed, among other things, precisely at containing, in the words of the Confindustria newspaper, the "overflowing marketing". And this downsizing policy has seen all the large pharmaceutical groups in the front row from Merck Sharp & Dohme to Pfizer, from AstraZeneca to Bayer and Roche, a long list that includes all the top twenty companies by turnover in Italy. So less marketing and more innovation? On the issue, the US journal Plos Medicine has just published a study by two Canadian researchers who question the numbers provided by IMS Health, probably the world's leading authority in defining the distribution of expenditure by pharmaceutical companies.
The latest data provided by IMS is under discussion, according to which pharmaceutical companies as a whole spend more on research and development than on marketing: 29.6 billion dollars against 27.7 spent on all promotional activities. Figures to be reviewed, say the researchers, because they are not accurate enough. An accusation not just motivated by at least three reasons. First of all, the fact that the data is taken directly from company budgets, which may underestimate some of the promotional costs, since the expenses of meetings sponsored by pharmaceutical companies are not included in the overall budget, and therefore that trials aimed at promoting prescribing new drugs. To challenge this figure of 27.7%, in their opinion not very accurate, the researchers resorted to data provided by CAM, a company that deals with global market research, aimed in particular at doctors and to monitor their relationship with companies pharmaceuticals. The data collected was compared, determining the numbers of both organizations in the single categories of expenditure for the promotion, until arriving at an estimate of the total expenditure. It must be said that CAM considers a representative sample of 2000 general practitioners and 4800 specialists and only in the United States. With the new assessments, from the point of view of the doctor instead of the companies, the figures change and not a little. Pharmaceutical marketing spending comes in at $57.5 billion versus IMS's $27.7 billion. More than double. And even the researchers say the figures may still be incomplete. The truth perhaps lies somewhere in the middle, in the sense that, if the numbers provided by companies can be unreliable, the same can be said for the answers given by doctors to the questionnaires which are not necessarily irrefutable. The study somehow opens the debate, in the hope of the researchers that the pharmaceutical industry will move
