There is a further aspect to this. Advance information about the compounds that a company has in its pipeline may have a substantial impact on the company's share price. Stock brokers employ analysts to pore over the proceedings of pharmacology conferences for indications of what may be forthcoming. Based on this there may be considerable shifts in market capital.
As a consequence, companies have a predilection for the 'rational' development of drugs. Rational development in this context means that the drugs are produced as the consequence of some established theory.
**Companies want you to think that all the 'science' has been done before a drug comes to the marketplace, and all that remains is for a clinical trial to confirm the predicted benefits. The belief that drug development is a rational process and that all the significant science has been done before a launch is, however, at odds with the evidence.**
Most major breakthroughs, like Viagra, for instance, still come about essentially by accident. Observations that the drug is doing something that was not predicted pose serious problems for companies - they upset the balance sheet of profits and potential liabilities.
Far from being grateful when new observations are pointed out and new uses indicated, drug companies are liable to be less than enthusiastic. **The interesting observations of consumers or their keyworkers are a problem, even where these interesting observations might offer the prospect of increased sales.** They do so, but at an uncertain cost. If these drugs are doing something we do not know about, what else might they be doing that might be a potential liability?
Added to this company disinclination to have new information come to light is the fact that they spend large sums of money understanding prescribers better than they understand themselves (currently approximately £30 000 per doctor per annum). Everyone has heard about the free conferences in exotic locations or under-the-counter gifts, but **the key marketing lies in the use of randomised controlled trials (RCTs) and in being able to deny access to the data from these trials and ghostwrite the publications from the trial to the point where even negative trials are described as positive studies.** The intense marketing of drugs has all the characteristics of any other marketing enterprise (...)
