Article Text

Download PDFPDF
Challenging pharma: who cares?
  1. Adriane Fugh-Berman1,
  2. Michael Wilcock2
  1. 1 Georgetown University Medical Center, Washington, Washington, USA
  2. 2 Pharmacy, Royal Cornwall Hospitals NHS Trust, Truro, UK
  1. Correspondence to Professor Adriane Fugh-Berman; ajf29{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


In this article, we discuss the role played over the past 20 years by groups, organisations and individuals that have been critical of the pharmaceutical industry. Such criticism has focused on some of the tactics used by the pharmaceutical industry including the overpromotion of ineffective, inferior, dangerous or too-expensive therapies.


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 …

View Full Text


  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.