Silverman M, Lee P R, Lydecker M
Int J Health Serv. 1982;12(4):585-96. doi: 10.2190/2VQV-KU9Y-FVPX-N4B6.
This article reports an investigation of the promotion of more than 500 products marketed by over 150 pharmaceutical companies in the United States, Great Britain, Latin America, Africa, and Asia. In contrast to the promotional material provided to physicians in the United States and Great Britain, material presented to physicians in Third World countries was found to be marked by gross exaggeration of product effectiveness and minimized or completely omitted potential hazards. No substantial differences could be found between multinational and domestic companies, brand-name and generic firms, or companies based in capitalist nations and those in socialist or communist-bloc countries in terms of the adequacy and accuracy of their promotion. Little evidence was found to support industry claims that the discrepancies in promotion reflect the different policies of various drug regulatory agencies. Much of the promotion concerned "luxury products," including costly tonics and appetite stimulants marketed in poor countries where the pressing need is for food. Bribery of influential physicians and key governmental officials may play an important role in irrational drug promotion and use in the Third World. Some of the proposed corrective approaches to this problem are examined.
本文报道了一项针对美国、英国、拉丁美洲、非洲和亚洲150多家制药公司所销售的500多种产品促销情况的调查。与提供给美国和英国医生的促销材料相比，发现提供给第三世界国家医生的材料存在对产品疗效严重夸大，而对潜在危害则尽量缩小或完全省略的情况。在促销的充分性和准确性方面，跨国公司与国内公司、名牌企业与非专利药企业，或者资本主义国家的公司与社会主义或共产主义集团国家的公司之间均未发现实质性差异。几乎没有证据支持制药行业称促销差异反映了各药品监管机构不同政策的说法。许多促销活动涉及“奢侈品”，包括在急需食品的贫穷国家销售的昂贵滋补品和食欲兴奋剂。贿赂有影响力的医生和政府要员可能在第三世界不合理的药品促销和使用中起重要作用。本文还探讨了针对这一问题提出的一些纠正措施。
