[Athena] Drugs and the birth of scientific marketing

[Jean-François PICARD <jean-francois.picard AT mouchez.cnrs.fr>]

Cher(e)s collègues,

Voici l'annonce d'un colloque qui serait susceptible d'intéresser
certain(e)s d'entre vous.

Bien cordialement

Jean-Paul Gaudilliere


Call for papers

Drugs and the birth of scientific marketing

Final conference of the GEPHAMA research project.
Berlin, June 4th-5th, 2012.


Drugs are granted particular meanings within the vast constellations of
industrial products whose coming into being and use rest upon complex
arrangements of academic and private research, professional expertise,
mass production and global commercialization.
Drug companies are perceived as typical examples of modern
industrialization, which are at the very forefront of capitalism.  They
are highly valued on stock exchanges as they promise high profits. This
situation has emerged since the late 19th century, when the pharmacists
increasingly lost their function to buy and sell drugs and to produce
medicaments on the prescription and under the control of doctors. Parallel
the products changed their image as to come into life by the research
activities of pharmaceutical firms, which require high investments in
research, in systematic screening and large scale clinical trials. These
risky investments were and still are justified by the expectation of
repayment through sales and protected by intellectual property rights and
market regulation. Especially during the second half of the 20th century,
the cost of research and development grew. So did competition, while the
number of entirely new molecules and substances put on the market rapidly
declined after the golden 1950s-1960s.


As a consequence of these constraints, marketing has evolved as a
technique to identify and develop new medical markets, to secure the
research investments and to increase the return on investment. The
industrial transformation of drugs in the 20th century is therefore not
only based on the changing scale and nature of their mode of production,
but also on the fact that they have become normal goods, targets of
intellectual property rights and market construction. While pharmacy,
therapeutic practices and medical markets changed decisively marketing has
become a central and publicly criticized practice. Much of this critique
goes back to the traits that are seen to distinguish pharmaceutical from
other technoscientific products. First of all, market construction and
public health have often been at odd, drug safety, efficacy and access
have been and still are the topic of public controversies. Secondly, the
market for drugs is different in so far as third parties like the
prescribing physicians, health insurances and public health institutions
act as gate keepers.  Thirdly: Pharmaceutical markets are strongly
regulated. Had the regulation of the manufacture, sale and consumption of
pharmaceuticals initially favoured professional regulatory bodies, later
complex administrative agencies in charge of pre-marketing, evaluation and
of the surveillance of routine uses in order to detect and limit adverse
events evolved. From this perspective, the industrialization of
pharmaceuticals has been a matter of changing power balance between the
different actors making drugs.

The aim of this conference will therefore be to make accessible original
investigations of pharmaceutical promotion as a series of local –
industry-based - practices linking research, market and medicine and to
discuss the transformation of drug markets and their construction during
the last century. The socio-historical scenario grounding this call
originates in the original research hypothesis of the ANR-DFG research
project GEPHAMA, which distinguishes two regimes of promotion.

The first regime may be called that of advertisement or propaganda. It was
barely specific to the drug sector and rested on the massive practice of
announcements in popular as well as scientific journals hardly
distinguishing physicians and patients and focusing on drugs originating
in various combinations of substances included in the pharmacopoeia,
usually sold without prescription. The second model is that of scientific
marketing. It is based on a vast palette of promotional techniques
targeting physicians rather than patients and focusing on the
‘scientifically’ proven properties of new proprietary substances. Given
the new – industrial – mode of drug invention and production, the success
(or failure) of a given pharmaceutical enterprise was largely dependent on
physicians knowing about the drug in question and being prepared to
prescribe it. As an effect of this transformation, firms started to
develop new advertising practices. If in the past, advertising was mostly
targeting the layman the new techniques of scientific marketing addressed
the physician as public expert and gatekeeper of medical applications.
Firms started to mobilize forms of information emphasizing the scientific
dimension of their activities and products, for instance expanding the
system of drug representation. However, it was only after 1945 that
marketing in the narrower sense of the word (with its instruments for
systematic ‘research’, market observation and customer surveys) was
professionalized and firmly established in the pharmaceutical sector.

The new model of scientific marketing is certainly not just the product of
this internal dynamics of promotional activities. It has also roots in the
increasing emphasis drug regulation placed on clinical research. The
consequence was a considerable blending of marketing activities and
clinical investigations. At the same time, drug advertising was
re-regulated with legal sanctions introduced in most European countries.
During the post-war period the changing nature of therapeutic agents as
well as an escalating consumption resulted in highly visible drug scandals
(the Contergan scandal, the DES affair and many more), which served to
open up a wide public debate about the role of marketing, during which new
activist groups and alternative networks of practitioners claimed to be
public health defenders. As reaction, scientific marketing started to
entail channels of patient information and education advocating patients'
ability to medicate him- or herself, his or her responsibility for his or
her therapeutic regime, as perfectly illustrated with the trajectories of
diabetics’ associations or the promotion of 'life-style' drugs like the
pill.

Beyond the documentation and critical evaluation of this socio-historical
scenario, the aim of the conference will be to approach the issue of drug
consumption through the lens of science-based market construction. Social
studies of consumption often sees the practices of buying, use, and
disposal of goods in the context of discourses, emotions, and rituals, and
socialization. This cultural approach however tends to forget uneven
powers, hierarchies and their decisive influence on the making of
knowledge, expertise and medical practice.

The conference will be organized in three thematic session respectively
dealing with: 1) Professionalization, media and forms of marketing; 2)
Regulation, consumption and the construction of markets; 3) Marketing,
drug uses and the redefinition of diseases. Papers may address any one of
these issues through studies of firms, products or specific tools. Given
the emphasis the GEPHAMA project placed on the historical trajectory of
pain killers, psychotropic drugs, hormones and anti-diabetics, priority
will be given to papers investigating these drug classes.

All costs of participation will be covered by GEPHAMA funding. Proposals
for papers should be send to Jean-Paul Gaudillière (gaudilli AT vjf.cnrs.fr)
and Ulrike Thoms (ulrike.thoms AT charite.de) before March 15th, 2012.





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