Background

The success of COVID-19 vaccines has been seen as a reason for celebration by the pharmaceutical industry, which hopes to repair its long-tattered reputation.1 Pharma marketing and promotional activities across the globe have been scrutinised, debated and criticised for decades in the form of articles in widely-read general medical journals and less well-read specialist journals as well as a plethora of books.2–5

Pharma marketing activities are highly sophisticated and far-reaching, affecting not only healthcare providers but also payers, governments, legislators, regulators and the media. While many in healthcare recognise pharmaceutical sales representative visits, medical journal advertising, and, in some countries, direct-to-consumer advertising as pharmaceutical promotion, fewer people are aware of the many other marketing tactics in play.6 It is clear that there is still a need to take a critical look at pharmaceutical marketing activity in all its forms, be it promotion of disease,7 8 the ever-greening of medicines9 or efforts to justify the high cost of medicines.10 In addition, there are recent concerns over homogenising research/evaluation/healthcare delivery with industry and a view that governments, healthcare services and other organisations are becoming, although unwittingly, marketing partners with industry.11 For example, in the UK, the National Institute for Health and Care Excellence, the National Health Service and the government use marketing language in their press releases (eg, ‘groundbreaking’, ‘brilliant’, ‘cutting edge’ and ‘potential game-changer’) that promotes new medicines such as ▼inclisiran.12

Finally, patient advocacy organisations are too pharma-friendly, taking industry money in return …