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Gephama - From publicity to scientific marketing: companies, physicians, and building pharmaceutical markets

ANR contract 2009-2011
Coordinators: For the German part: Prof. Dr. Volker Hess (Charité-Universitätsmedizin Berlin), for the French part: Jean-Paul Gaudillière (Cermes3)

From publicity to scientific marketing: companies, physicians, and building pharmaceutical markets

A study of the changes in the relationship between science and drug markets in the twentieth century

Since the early 1990s, the history of pharmacy has been deeply renewed by an increased interest in the production of knowledge, the “trajectories” of drugs, and the regulation of drug markets. Paradoxically, this new historiography has not taken marketing as its object even though pharmacy was, in the first half of the twentieth century and in terms of the scale of its investments, a producer of publicity and advertisements. The goal of the Gephama project was thus to undertake a comparative history of pharmaceutical publicity in the twentieth century in France and in Germany, a history simultaneously taking into account the knowledge, the practices, and the uses of the drugs that were the objects of this publicity. The idea was to focus not only on the marketing activities of the companies and publicity professionals, but also on their links with research, prescription and clinical work, and drug laws and regulations. The project intended to provide better knowledge of what pharmaceutical marketing was and still is today in order to avoid a twofold trap: that of explanations of the type that professionals were “captured” by an industry generating “false” needs; and that of readings in terms “of exception” seeing in the development of drug markets a problem of innovation slowed down by bureaucratic regulations.

A comparative history of marketing practices: from advertising to scientific marketing

To analyze the construction of drug markets in France and Germany in the twentieth century, the project intended to privilege the practices of firms and companies and focused on a limited number of therapeutic classes: analgesics, sleeping pills and psychotropic drugs, sex hormones, and antidiabetics. The starting point was to periodize two systems, and this periodization was confirmed and fine-tuned through cross-investigation:

1 - Advertising, which dominated until the 1930s, is characteristic of a period when the industry and dispensing pharmacist (directly in charge of preparing therapeutic compositions) coexisted in a conflictive way. In this world, promoting specialties was often about promoting a name (a trademark could be obtained but not a patent); the main channels were advertising and written communications; the targets were both patients and physicians (all the more so that many specialties were sold directly to them).

2 - Scientific marketing became the dominant vector only in the 1960s, when the industrial reorganization of the sector had been completed. The move to marketing reflects a “professionalization” of promotion associated with a change in scale of marketing campaigns, with the integrated use of a whole pallet of tools targeting physicians rather than patients (medical sales representatives were an essential part of these). But it also reflects a “scientification” of promotion, which took place on two levels. On the one hand, in connection with the therapeutic revolution and the change in scale of the markets, there was an increase in the use of the results of biomedical research (laboratory and clinical). In addition, marketing became, during the same period, a research activity.

The most important results are related to the emergence of the scientific-marketing system and its characteristics. This latter appeared, in France as well as in Germany, as an integrated system of pharmaceutical promotion in the postwar period, although in Germany the transition had begun as early as the 1920s. It fell under a more general configuration of large capitalist companies, not specific to pharmacy, which were dominated by engineers and technical experts, and a division-based organization. What was specific to pharmacy was the importance taken by clinical research in building markets. The case of antidepressants eloquently shows, for instance, the looping effects between the new promotion practices and the physicians’ diagnoses and prescriptions. Scientific marketing was not a simple response to health “needs” but a scheme to construct the latter by means of the market. This construction was based on medical knowledge but it also deeply modified it. In other words, scientific marketing changed the sense of indications, medical categories, and intervention standards: it was a redefining force of pathologies and their boundaries.

A database of publicities covering the period from 1915 to 1970 was created by selecting two journals addressed to general practitioners: for France, Concours médical, and for Germany, Deutsche medizinische Wochenschrift. In addition to the constitution and collective exploitation of this database, the project led to many publications, two of which presented the collective results:

1) a special issue of the journal History and Technology edited by Jean-Paul Gaudillière and Ulrike Thoms: Pharmaceutical firms and the construction off drug markets: From branding to scientific marketing;

2) a book in the collection Studies for the social history of medicine, published by Pickering & Chatoo: Jean-Paul Gaudillière and Ulrike Thoms (eds.): The Birth of Scientific Marketing (2014).

The Gephama project is a French-German research project in social sciences coordinated by Jean-Paul Gaudillière (Cermes3, Paris) and Volker Hess (Institut für Geschichte der Medizin, Berlin), supported by the ANR and the DFG. It started in December 2008 and was completed in September 2012.