FRAL - AAP franco-allemand

From Advertisment to marketing. Pharmaceutical enterprises, patients, physicians and the construction of medical markets – GEPHAMA

From branding to scientific marketing:

corporations, physicians and the construction of pharmaceutical markets.

A study of changing relationship between drug sciences and markets in the twentieth century

Since the early 1990s, the historiography of pharmacy has been deeply renewed due to the new interests in the production of drug knowledge, the regulation of markets and the study of drug “trajectories” from their inception to their uses. However, this new history has barely explored the<br />practices of commercialization even if pharmacy was already in the early twentieth century was already the first economic sector for its investments in publicity. The target of the GEPHAMA project was therefore to undertake a comparative history of pharmaceutical marketing in France and in Germany during the 20th century. The project aimed at a form of history taking into account the forms of knowledge, the practices of sales and marketing, the uses of therapeutic agents with an inquiry looking at the activities of pharmaceutical companies but also at the relationship they have maintained with medical and clinical work, with the regulation of drugs and the law. The perspective was to bring a better knowledge of what was (and is) pharmaceutical marketing but also to avoid two sorts of<br />ready-made explanations: the idea of “capture” according to which an all powerful industry create false needs by manipulating professionals and the idea of “exception”, which sees in the drug market a<br />field of innovation hampered by state regulations .

In order to analyze the construction of drug markets in 20th century France and Germany, the project has concentrated on the practices of firms and corporations and selected a limited number of therapeutic classes (painkillers, sleeping pills and psychotropic drugs, sex hormones and contraceptives, anti-diabetes).
The point of departure was a chronology distinguishing two regimes of drug commercialization in the 20th century:
1 – A regime of the brand, dominating before the 1930s, that is when the drug industry and pharmacies (where preparations were made) cohabited although with many conflicts. Within this world, promotion was a matter of name (it was possible to obtain trademarks but not to patent drugs);
it was chiefly organized around the circulation of printed material (like advertisements in journals) and patients as well as physicians were targeted (since many specialties were sold over the counter).
2 – A regime of scientific marketing, which dominates after the 1960s when the industrial reorganization of the sector was achieved. The transition to scientific marketing is linked to the professionalization of promotion and goes with a changing scale of campaigns, a diversification and integration of many tools (with the system of prep representatives at the center), the exclusive targeting of physicians. Marketing also becomes “scientific” in two ways: first, in direct with relation with the therapeutic revolution, biomedical research (both in the laboratory and in the clinic) becomes a marketing asset; second marketing itself becomes a research activity.

The main results of the project address the emergence of scientific marketing and its main traits. Scientific marketing appears as an integrated system of drug promotion after the Second World War. However, the transition toward this system starts earlier in Germany than in France, already in the 1920s and, in contrast to what has often been assumed, with barely any input from US techniques. Scientific marketing is deeply rooted in the structure of modern capitalist firms with its divisional organization and leadership of technical experts; in this respect it is not a phenomenon specific to pharmacy. What is unique to the sector is however is the relation to professional and the role clinical research plays in the construction of markets. The case of antidepressants for instance reveals in a striking manner the “looping” effects between the drug marketing practices and physicians’ diagnosis and prescription work. Scientific marketing is therefore not a simple response to health “needs” but a way to construct these needs through the markets. This construction takes into account medical knowledge but also deeply shape it. Scientific marketing changes indications, medical categories and norms of intervention: in other words it redefines pathologies and their boundaries.

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During the course of the project a publicity database for the years 1915-1970 has been created, gathering the advertisements for physicians published in two journals for general practitioners, Concours médical in France, Deutsche medizinische Wochenschrift in Germany. Beyond the design and common exploitation of this research tool, two edited volumes present the collective results:
1) a spécial issue of the journal History and Technology with Jean-Paul Gaudillière und Ulrike Thoms as guest editors: Pharmaceutical firms and the construction of drug markets: From branding to scientific marketing (in press).
2) A book in the series Studies for the social history of medicine Pickering & Chatoo : Jean-Paul Gaudillière und Ulrike Thoms (eds.): The Birth of Scientific Marketing (in preparation, to be published in 2014).

The project will analyze the marketing of modern drugs as an heuristic approach for understanding the modern medical market. The industrial mass production, the use of communications media in marketing, the specialization of and the differentiation within the medical market (inpatient or outpatient treatment), the increasing internationalization of the market and last but not least the blessings and promises of the post World War II "therapeutic revolution": All these trends have allowed for the evolution of an ever more complex network of actors, institutions, interests, and power structures. With the focus on a short 20th century (1914-1990) the project is conceived of as a comparative study between France and West Germany, as an "histoire croisee" (entangled history) which developments (scientific marketing) in their own specific national effects. This will especially be the case for the challenge posed by the US-American success in combining research with marketing. Which answers were found in each country-specific research, business, law, and social systems? What kind of French and German cultures of marketing developed out of the confrontation with American marketing methods?

Project coordination

Jean-Paul GAUDILLIÈRE (Organisme de recherche)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.

Partner

Help of the ANR 230,000 euros
Beginning and duration of the scientific project: - 36 Months

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