Lee P R, Lurie P, Silverman M M, Lydecker M
Institute for Health Policy Studies, University of California, San Francisco.
J Clin Epidemiol. 1991;44 Suppl 2:49S-55S. doi: 10.1016/0895-4356(91)90113-n.
Recent studies of drug promotion and labeling in Third World countries since 1972 have observed important changes in the policies of multinational corporations. Earlier studies found that multinational and national drug companies often grossly exaggerated the indications for the drugs and minimized or ignored the hazards. In the latest study, initiated in 1987, considerable improvement in promotional practices of the multinational corporations has been found, but little or no improvement on the part of the national companies. As a result, physicians are still provided with grossly exaggerated claims and the hazards of prescription drugs are covered up or glossed over. A very serious problem--the marketing of fraudulent drug products--has been identified in a number of Third World countries. Drug products are shaped and colored to resemble the original multinational company product, but contain only a small percentage of the active ingredient stated on the label, or perhaps none at all. In Indonesia fraudulent drug products may represent 20-30% of all drug products in the market. Similar fraudulent products have been reported in Brazil, Thailand, Bangladesh and Malaysia.
自1972年以来，近期针对第三世界国家药品推广与标签的研究发现跨国公司的政策出现了重大变化。早期研究发现，跨国和本国制药公司常常严重夸大药品适应症，对药品危害则尽量淡化或忽略。在1987年启动的最新研究中，发现跨国公司的推广行为有了显著改善，但本国公司几乎没有或根本没有改进。结果，医生仍会收到严重夸大的宣传内容，处方药的危害被掩盖或粉饰。在一些第三世界国家，已发现一个非常严重的问题——假药的销售。假药在形状和颜色上模仿原跨国公司产品，但标签上标明的有效成分含量极低，甚至可能根本没有有效成分。在印度尼西亚，假药可能占市场上所有药品的20%至30%。巴西、泰国、孟加拉国和马来西亚也报告了类似的假药情况。
