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The Ethics of Disease Branding

We’ve all seen the ads on TV. The number of pharmaceutical spots informing us of all the potential illnesses that may afflict us is increasing daily. What’s more, new diseases are sprouting up even faster. “Now that I’ve learned that I’ve got a disorder, it’s a good thing they’ve tailored just the pharmaceutical solution for what ails me. Don’t worry that it might cause anxiety, mania, amnesia, cancer, stroke or death (as well as who knows what else). But, hey, at least I won’t have that pesky disorder anymore!”

It’s easy to poke fun at some of those commercials for their contrived metaphorical situations and the litany of potential side effects, but often they do provide a valuable service. In fact, when properly executed, disease branding can create a new level of understanding of the seriousness or legitimacy of certain conditions.

For example, the term heartburn was coined decades ago by antacid brands, and suggests that the mechanism of action in the treatment of indigestion is acid neutralization, which is exactly what antacids do. However, researchers discovered in the 1980s that chronic heartburn could be further described as a malfunction of the esophageal sphincter, a more serious disorder that can lead to the erosion of gastrointestinal tissue over time and lead to certain forms of cancer. Glaxo and its drug Zantac worked to rebrand chronic heartburn as a more insidious medical concern, coining the term GERD (gastro esophageal reflux disease). Branding GERD not only shifted the public’s perception about the dangers of chronic acid reflux, it also put Zantac in the spotlight as the best overall solution. Acid blockage (which is what Zantac and other H2 antagonists do), rather than acid neutralization, implies that the problem should be stopped at the root of the condition, not after it manifests itself and does damage.

While the introduction of GERD and the resulting awareness of it and its treatment can have a meaningful impact on the quality of people’s lives, the proliferation of these ads and other questionable forms of promotion (such as paying incentives to prescribing doctors) does beg the question—where should we draw the line? At what point are pharmaceutical marketers trying to invent demand for drugs that need an ROI?

Obviously marketing has been “raising awareness” and “educating” the public about the benefits of their particular product for decades and quite a few times we’ve been caught going a little sideways to say the least. Tobacco, the poster boy for unethical marketing, was actually promoting the health benefits of smoking at a time they knew it would kill you. Unfortunately, it didn’t stop there and it’s usually not as black and white. Since then there have been numerous instances of shady promotional claims and practices across numerous sectors and we are bound to continue to see more.

I believe the key is not to point the finger at marketing alone, I think it’s important to realize that the problem usually goes deeper than that. It’s indicative of an underlying culture endemic to that company, industry or, at times, overall society that says it’s OK to keep pushing the envelope—until as Mom used to say “someone gets hurt.” The marketing department is just one place where this symptom can appear. Just look at the rash of accounting fraud that was uncovered in the wake of the Enron implosion, no marketing there but same underlying problem. It reflects a company’s values or lack thereof and their willingness to manipulate or ignore the moral questions that such behavior begs in order to achieve some sort of short term financial metric. After all, it’s not just marketing ethics or even business ethics, it’s just ethics and each one of us should hold ourselves responsible for our actions and those whose company we keep. After all, if the past three years has taught us nothing else, it’s that there is a true cost to business and society for losing sight of that.

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