AstraZeneca marketing Seroquel by the back door…

… oops, sorry I forgot, it’s not marketing is it… it’s just education.

A taster below from Dr Daniel Carlat – read the whole article here:

The second case is where things get more interesting, and where our summertime feast of CME bias really begins. This is a 30 year old man with bipolar disorder, already on lithium monotherapy, who presents with symptoms of major depression. The patient is started on Lamictal, which is TIMA’s first line recommendation for treating bipolar depression. However, unfortunately for GlaxoSmithKline (maker of Lamictal), the patient suffers unspecified “side effects” on Lamictal, and is therefore switched to AstraZeneca’s Seroquel, and gets better.

Oh, did I forget to mention that this article was funded by AstraZeneca, and that Seroquel was just approved by the FDA for the treatment of bipolar depression, and that AstraZeneca is in the midst of a major marketing campaign to encourage its use for this indication?

Now, let’s conduct an autopsy of exactly how this CME article is biased in favor of the sponsor’s drug. Case studies are a favorite technique used by medical education communication companies, because they are a way of spotlighting a particular product without appearing biased. Thus, apart from the case studies, this article is a fairly objective, if bland presentation of industry-supported treatment guidelines. The first case study endorses valproic acid and Risperdal, neither of which are in direct commercial competition with Seroquel, since Depakote is available generically and risperidone is a lame duck for Janssen, on the verge of going generic and being vigorously supplanted by Janssen’s “new” Invega.

No, the money for AstraZeneca is in getting Seroquel prescribed in favor of arch-rival Lamictal, which is itself being vigorously promoted in a series of GSK-funded CME programs (see my review of one here). The second case study takes place in a bizarre parallel universe in which patients have more side effects on Lamictal than on Seroquel, exactly the reverse of what we psychiatrists commonly see here on Earth. Unrealistic, perhaps, but it serves the sponsor well, telling the story of a patient who likes Seroquel. We don’t hear anything about Seroquel’s famous side effect of sedation, because that would reflect poorly on the company footing the bill.

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