One Way Big Pharma Trains Doctors

Written by Amy Denney on June 19, 2023. Posted in Current News

Digestive Disease Week sponsorships put drugs front and center, but research says lifestyle should lead the way

Claire Davidson was socializing with colleagues at the Digestive Disease Week conference when the group realized the table they were gathered around was covered with advertisements.

Anywhere else, a table wrapped in brightly colored pharmaceutical branding might stick out, but this small table fit in amid the sea of advertising in its enormous home.

McCormick Place, with its 170 meeting rooms and 2.6 million square feet of exhibit halls, is North America’s largest convention center, a small town inside the city of Chicago.

Greeting thousands of guests in the grand concourse were larger-than-life vinyl banners—one just inside the main entrance hanging 75 feet by 30 feet—and vinyl advertisements on the stairs, the stair rails, windows, and stacked cubes.

Sitting areas beckoned weary conferencegoers with comfortable seats, tables, and charging stations all plastered with company colors and logos. Even the information booth was wrapped in branding.

Image: Amy Denney

“You can’t get away from it. I think it’s a little out of hand,” Davidson told The Epoch Times. She’s the research lead with Mindset Health, a company that researches and develops hypnotherapy solutions for disease. “The amount of money they spend on it is unbelievable.”

Together with registration fees, sponsorships help cover conference costs for doctors, students, researchers, and industry professionals from more than 100 countries to gather and learn about the latest studies and products that can help people with digestive problems. Many also attend to earn necessary hours of continuing medical education (CME).

An Epoch Times review found that sponsorships for the Digestive Disease Week (DDW) conference—predominantly from pharmaceutical companies—appear to represent more than half of conference funding.

In contrast, the research presented over the course of the event seemed to favor lifestyle solutions rather than drugs. Events such as DDW reflect an ongoing concern in health care that’s not being addressed: Pharmaceutical companies dominate health care, reinvest profits in marketing, and continue to influence patient care in a feedback loop that runs counter to the bulk of evidence.

“When do we stop looking at health care as a business instead of a healing tool?” Dr. Sabine Hazan, a gastroenterologist and CEO of Progenabiome, told The Epoch Times. “When do we let doctors practice the art of medicine without influence?”

Consequences of Influence

DDW is the norm among medical conferences in that continuing medical education is funded primarily by drug and medical device manufacturers. Because these events are considered education and not advertising, they slip under regulatory radar, according to Dr. Adriane Fugh-Berman, professor of pharmacology and physiology at Georgetown University.

In her 2021 essay on industry-funded education published in the BMJ, Fugh-Berman said studies show that most doctors do not believe that sponsorship of CME events creates bias, despite research indicating otherwise.

“Studies analyzing content have shown consistent messaging in industry-funded CME that favors sponsoring companies’ drugs and disadvantages competing products,” she wrote. “The messages work: commercial CME affects prescribing choices.”

She cited two studies: a tripling in the prescribing of an antipsychotic that followed a manufacturer-paid speaking presentation at the Minneapolis Veterans Affairs Medical Center and a doubling of prescriptions for the sponsor of an all-expenses-paid CME symposium held at a tropical resort.

A Medical Conference by the Numbers

The Epoch Times asked the organizers at DDW for information on its total cost and the breakdown of income from sponsorships, vendors, and registration fees. Courtney Reed, manager of communications and media relations for American Gastroenterological Association, responded by email that the information cannot be shared.

The association is a co-sponsor of DDW, along with the American Association for the Study of Liver Diseases, the American Society for Gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.

Sales figures compiled from the DDW sponsorship website show that more than $3 million was generated in McCormick Place sponsorship opportunities. That’s on top of an unknown sum from exhibition booth space rental fees. A low estimate of at least $2.5 million was brought in from registration fees, based on 2022 attendance numbers (nearly 13,000 in person and online) and fees that began at $210.

Most of the sponsorships at DDW were pharmaceutical and medical device companies. For all the splash they generated in marketing, neither industry received top billing in the research presented. Reed didn’t offer specific percentages but referred The Epoch Times to the online planner and app, where all the sessions and abstracts can be found.

A quick search on the DDW app for the terms “drugs,” “pharmaceutical,” and “procedure” produced a combined 121 hits. On the other hand, searching the words “diet,” “nutrition,” and “lifestyle” yielded 566 hits for papers and topics presented. There were more than 1,000 sessions at the event.

When asked why sponsorships didn’t line up with solutions reflecting that digestive disorders are largely the result of diet and lifestyle choices, Reed wrote in an email that “there have not been any conversations to our knowledge about this.”

Glitz and Giveaways

One end goal of the marketing at DDW was to entice visitors to specific booths in the massive exhibition hall. Even the DDW app was full of ads. Each time users opened the app on their phones, they were greeted with a Pfizer popup message inviting them to visit its booth to explore the company’s “commitment to gastroenterology.”

Once inside the hall, visitors were swallowed by a cacophony of colors, noises, and even smells—far more exciting than the stuffy, dark classrooms where researchers presented findings in monotone. In many ways, the important research findings presented at the conference played a dull second fiddle to the vibrant branded “booths” as big as retail stores.

Visitors were lured into those spaces by free treats such as a coffee and pastries or frozen yogurt with a dozen toppings. There were games, interactive exhibits, and offers to gather for a free dinner and lecture off-site.

Tucked behind the booth space against a dull backdrop was often a lonely-looking table with a person or two representing the medical/research arm of the company. Marketing took sharp visual precedence over education.

None of that research or any of the smaller booths was featured on DDW TV, a channel with about a dozen professionally produced, upbeat videos from this year’s event.

One video was a tour of the free food in the exhibit hall, and another featured splashy technology that pharmaceutical companies used to grab the attention of passersby, such as a giant walk-through esophagus showing inflammation and a “man in the box” hologram of Dr. Paul Feuerstadt, a gastroenterologist and assistant clinical professor of medicine, touting the benefits of a newly approved drug.

The video’s announcer said, “Don’t miss your opportunity to visit face-to-face with some of the companies that are leading the advancements in digestive health care.”

In some cases, the line between conference content and advertising was blurred, as with “product theater,” sessions presenting case studies and trials. Each session—there were 25 in all—was actually a purchased marketing opportunity that cost $25,000 and went in the program app along with all other sessions.

About 70 percent of attendees had prescribing capabilities, according to DDW sponsorship marketing information, and physicians were the target of marketing well before the event. One company paid $25,000 for an ad on all pre-conference emails, and several paid $10,000 to $20,000 for single email blasts in the days leading up to the conference.

Anyone staying at the Hyatt Regency at McCormick Place was hit with marketing at the check-in desk, around columns in the lobby, and on digital screens throughout the hotel before they even set foot in the venue.

There was even a billboard being towed on a flatbed trailer up and down Martin Luther King Jr. Drive in front of McCormick Place.

Dr. Luis Caro, gastroenterologist and director of Argentina-based Gedyt—a gastroenterology group—said he anticipated marketing but not the ostentatiousness, of the exhibit hall especially. “It’s too much. It’s trash for my eyes,” he said.

The Sales Game

Caro was wandering in a quiet row of small booths—some just consisting of a table, a small banner, and a couple of chairs—on the hunt for research-driven, side-effect-free treatments that would benefit his patients. Most booths with lifestyle solutions—diet, stress, supplements, and testing not covered by insurance—lined the back of the hall.

Davidson said she met many sincere physicians at her booth looking for nonpharmaceutical options. Most doctors, she said, wanted to see the studies they included in a folder they were handing out and completely ignored the simple one-page marketing sheet.

“I think doctors are so used to being sold to. I think they have to tune it out,” she said.

Her co-worker, Dr. Anthony Tang, was mesmerized by efforts that companies used to cut through the noise and get their message out to the throng of conventiongoers. His company’s strategy aligns with its budget: Let the research do the talking, form relationships with doctors, and listen to their needs.

“Don’t get me wrong—if I had the option to put a big ole billboard up somewhere, I’d do it,” Tang, health care relationship lead, told The Epoch Times. “The more frequent and the more recent you are in someone’s mind, the more likely they are to make the informed decision on whether or not your product is the right product to use.”

Drug companies are simply using a common marketing ploy, he said, popularized by companies such as Nike, Coca-Cola, and others. Bigger budgets afford the opportunity for large, repeated ad campaigns with staying power.

“It’s a fun environment to be in,” he said of DDW. “It’s a big ole game. You’ve just got to leverage what you can leverage, and everyone’s trying to do good.”

Bias, Business, and Misplaced Trust

Some may not be doing good though, and the concern that sponsorships may cause bias has led some organizations to put on conferences without the support of Big Pharma or Big Tech. One of those, PharmedOut, has been holding pharma-free CME conferences since 2010.

The Society for General Internal Medicine doesn’t accept funding from for-profit companies at its national or regional meetings. Instead, you’ll find medical organizations, health systems, and nonprofits in its expo and career fair.

In 2008, the Oregon chapter of the Academy of Family Physicians decided that no grants would be used for its continuing education seminars, and drug companies are no longer allowed to have booths in its exhibit hall during conferences.

Both examples were pointed out in a 2021 Journal of General Internal Medicine opinion article on the Physician Payments Sunshine Act. The authors wrote that transparency hasn’t worked to change doctor behavior in relation to conflicts of interest with pharmaceutical companies.

Enacted by the Obama administration as part of the Patient Protection and Affordable Care Act, the Sunshine Act was intended to clean up the bias. Since 2014, it has required disclosure of payments from drug companies and device manufacturers to physicians, physician assistants, advanced practice nurses, and teaching hospitals.

An online open payments database allows anyone to search that information.

At DDW, each session was preceded by conflict of interest statements. Papers offer them, too. But according to the article, most patients fail to seek out the information. Only 12 percent know about the database, and just 5 percent have knowledge about whether their doctors have received payments.

Worse than that, disclosures of conflicts of interest may actually increase the potency of marketing because those professionals who are transparent in conflicts of interest may be viewed as honest and trustworthy.

It could also give an author or speaker “moral licensing and a concrete reason to present biased information.”

“[Disclosure] does not cleanse tainted information, straighten distorted perspectives, or filter out marketing messages,” the article reads. “Disclosure may lull audiences into believing, wrongly, that they can extract unbiased information from a biased presenter.”

See more here theepochtimes

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Header image: The Mirror

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