Lies, damn lies, and marketing...

Lies, damn lies, and marketing...

Ah, Twain. The father of so many of our oft-used turns of phrase, including this gem (which he attributes to Disraeli, though it's not present in any of that statesman's published works) from his autobiography:


"There are three kinds of lies: Lies, damn lies, and statistics."


Well I'm here to tell you that ALL THREE KINDS of lies (and more) are routinely told about prescription drugs. And innocently enough, all of these shameless prevarications bear the same innocuous name: Marketing. Now, I know what you're thinking: C'mon, doc, this is nothing new. Companies always lie - with or without the statistics - to try and sell you something...

That's true. In fact, you may remember me saying the exact same thing about the cancer drug Tamoxifen. Touted as the "magic bullet" for Breast Cancer prevention (some claimed a cancer risk reduction of up to 50%), in reality even the most favorable studies showed Tamoxifen cutting Breast Cancer risk by only 1%. Oh, and it INCREASED the risk of other female-specific cancers into the bargain - a fact that I'm sure wasn't exactly front-and-center in the sales brochure...

So how can drug companies get away with overstating the so-called "benefits" of their poisonous products? With the magic of statistics - specifically, by obscuring the distinction between RELATIVE risk and ABSOLUTE risk. Confusing, I know, but bear with me and I'll explain - using a current example you're sure to hear a lot more about in the near future: A new "wonder drug" for heart disease called the Polypill.

The Polypill is nothing more than a "cocktail" of existing heart drugs whipped up into a once-a-day pill patients will be expected to take for years on end - maybe even the rest of their lives (cha-ching! $$$) - for the prevention of heart disease and coronary events. The claims made by this drug's makers are awesome indeed. Among these is a claimed 34% rate of prevention for heart attacks. What's this based on? Smoke and mirrors. Here's what I mean...

In one study, the Polypill group suffered heart attacks at a rate of 2.7%, while the placebo group endured a slightly higher rate of 4.1%. The ABSOLUTE risk reduction associated with the drug is a paltry 1.4%. Hardly enough benefit to sell billions of dollars worth of pills. But since 2.7 is only 66% of 4.1, the RELATIVE risk reduction is 34%. Much more impressive when you say it that way, isn't it? Meaningless, but impressive.

Now, which of these numbers - 1.4% or 34% - do you imagine is most likely to show up in the marketing materials (both to doctors and directly to consumers) of this new "miracle drug?"

The big, dramatic, and TOTALLY MISLEADING one, of course.

Folks, this is par for the course for drug marketing. And what's even scarier is that this kind of statistical charlatanism is becoming so slick and so polished that even formerly credible sources like peer-reviewed medical journals are often unwittingly co-opted into becoming marketing accomplices for the drug giants. Don't believe me?

One need look no further than the June 28th issue of the British Medical Journal for proof. In it, the editor of that magazine is so swayed by the one-sided presentation of the "evidence" supporting Polypill that he wrote an editorial praising it himself!

So much for objectivity, huh?

WC Dougless, M.D.
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