The grass is always greener

By Natalie Brandweiner, Deputy Editor

How pharmaceutical companies influence patient groups to create a grassroots demand for their products.

“The timing of the donations is often carefully planned by the drug companies to coincide with their marketing strategies”

A term first used by former US Senator Lloyd Bentsen, Astroturfing has come to be known as the imitating or faking of popular opinion or behaviour. Within the pharmaceutical industry, it is the name given to the behind-the-scenes funding of prominent patient representative groups by some pharmaceutical companies.

Such close-knit relationships between drug companies and patient groups throws the integrity of both parties into question. But should the drug firms bear the brunt of all the negative press, or should patient groups be dealt just as much responsibility for accepting their funding?

There are very few patient groups that are transparent about funding: how much they get and how they arrived at that figure. Non-profit organisations are not required by law to outline the sources of their funding or how much they may be storing in their kitties. It’s only through careful examination of tax returns and annual reports that detailed figures can be arrived at.

As representatives of those affected by certain diseases, the function of patient groups is to offer support to the public, with the patients as their primary concern, campaigning for treatments and sitting on advisory committees. Although some patient groups are large and powerful, many are small and are subject to the financial and lobbying restrictions. For those with little or no lobbying power and only a small membership in tow, there is a perhaps understandable temptation to accept the readily available funds from pharma companies to help fund their activities and prolong their existence.

And why shouldn’t the drug companies seize upon these opportunities? They are looking to make a profit like any other business; their stock price will always be among their primary concerns. By filtering their marketing message into patient groups, drug firms can reach the public in a very effective way. The problem with this being that so many people place their trust in the groups they believe are representing them, and have limited awareness that a group’s agendas and actions may be influenced by its ties to a pharmaceutical company.

The timing of the donations is often carefully planned by the drug companies to coincide with their marketing strategies. For example, Pfizer was a major fund provider to the Restless Leg Syndrome Foundation in 2003 and 2004. However, after the company announced plans to stop manufacturing, its candidate RLS drug in July 2004, all donations to the patient group stopped.

Influence
A study undertaken by the New Scientist magazine in 2007 to investigate the extent of influence by drug firms on patient groups attempted to find out exactly how many dollars were being used to buy marketing power. In certain cases, the donation funds were huge; the American Heart Association, for example, was found to have received more than $23 million from drug companies, and the study found that in total, seven groups received more than 20 percent of their funding from drug firms.

However, are the drug companies really all to blame for the controversial astroturfing? Just as the funding provides the pharma firms with influence, it also brings significant benefits for the patient groups. Some groups argue that without the funding, they would be unable to operate, and with the additional funds they are able to serve more patients than if they excluded drug firms altogether.

However, many critics claim that even if the level of transparency of a patient group is extremely high, it still loses its claim to objectivity and cannot properly represent its patient group if it receives funding from a specific group, pharma or not.