Sunday, January 29, 2012

Marketing Drugs, Then and Now

Posted by Darin Hayton on 01/29 at 12:06 PM

The NY Times reports today on the direct marketing of pharmaceuticals: “Have These Symptoms? Buy This Drug.” The short article is based on a study by Mary Ebeling: “‘Get with the Program!’: Pharmaceutical Marketing, Symptom Checklists and Self-DiagnosisSocial Science & Medicine 73 (2011): 825–32.1 I fear Mary’s article is behind a paywall, but you can read the abstract at Social Science & Medicine and the NY Times’s article.

As should be clear from the titles, the point of these articles is to understand how drug companies have capitalized on the authority of the checklist to get people to self-diagnose and thereby to sell product and develop brand loyalty. This seems the obvious consequence of allowing direct drug company-to-consumer marketing. Unsurprisingly, when you think about it for a second, these checklists often adopt “watered-down and potentially more inclusive descriptions” of symptoms that physicians would typically use. Also not surprising is the fact that drug companies often obscure their vested interests and their role in creating these checklists.

When I read this I immediately recall the 19th- and early-20th-century patent medicine industry. Like today, the producers of drugs could market directly to consumers. And like today, they exploited a variety of techniques to generate sales and to establish brand loyalty. They did so through massive ad campaigns and through the distribution of free booklets and yearly almanacs. These booklets were filled with vague descriptions of symptoms and ailments, as well as testimonials and illustrations of product.

For example, here is a page from The Peruna Almanac for 1905.

A page from the Peruna Almanac for 1905 showing two early “checklists” of symptoms (Source: Author’s Collection)

In addition to the astrological information, there are two “checklists” and four testimonies for Peruna.

While the checklist had yet to evolve into the authoritative version we know today, Peruna and other patent medicine companies used a version of a checklist:

The “checklist” for Catarrh of the Throat along with Congressman Wilbur’s endorsement of Peruna (Source: Author’s Collection)

Here we see, in watered-down and ambiguous terms the symptoms of Catarrh of the Throat—as if “catarrh” isn’t already sufficiently watered down:
  • Gagging in the morning, and hawking up stringy mucus.
  • Enlarged tonsils, and sore throat at times.
  • Snoring when lying on the back.
  • Elongated uvula, and ulcerated patches in the throat.
  • Throat very dry, necessitating clearly throat often.
  • Coated tongue, and inside of throat read.
  • Throat smarts and tickles inside.

I like that last symptom the best. What exactly is “smarts and tickles”? Each month in the almanac there is a similar checklist of symptoms for a different form of catarrh. By the end of the year, nobody could escape suffering from a handful of catarrhal ailments.

This list of symptoms is paired with an image of Congressman D.F. Wilbur and his testimony, as well as the catchy little endorsement, the soundbite: “Pe-ru-na is All You Claim for It.”

Plus ça change!

For more on patent medicines, see the earlier posts: Medicines for the Faithful and Wright’s Indian Vegetable Pills and Dr. Jayne’s Family Medicines and Quack Medical Cures and Selling Medicines in the Late 19th and Early 20th Century.

The difference, if there is one, between today’s direct marketing campaigns and the 19th century seems to lie in the overt nature of the campaigns. A century ago, patent medicine companies never shied away from owning their message. In fact, they celebrated their role in producing propaganda for their products.

1Full disclosure here, I know Mary but did not know of this study before reading about it in the paper today.

Tags: mary ebeling, patent medicines, pharmaceutical industry