Physicians, Academic Health Centers, and Pharmaceutical Companies' Marketing Campaigns: A Perspective from the "Real World of Rodeo Drive"

An article in the Los Angeles Times opened an intriguing window into relationships between physician, pharmaceutical companies, and academic health centers involved in pharmaceutical companies' efforts to increase awareness of conditions for which they plan to market treatments. The article focused on Dr. Jennifer Berman, a urologist with an interest in women's sexual health. Berman came to the UCLA Health Center from Boston University to open a Female Sexual Medicine Center.

• After participating in a conference to define "female sexual dysfunction," funded by eight pharmaceutical companies, Berman found, "It was at its peak, all of the schmoozing and wining and dining. Every night you're out - one night with Bayer, the next night with Pfizer."
• "While in Boston, Berman began consulting for Pfizer, Bayer, Procter & Gamble, Eli Lilly - 'All of them.' According to Berman, the companies figured out that 'Hey, she's pretty and nice and great, and can communicate.' They asked her to do educational campaigns. 'Once you deal with the marketing side,' she says, 'there's usually more resources.'"
• "While at UCLA, Berman was a paid drug company expert for media campaigns that publicized low female libido and other maladies. By her account, Pfizer paid for studies she developed and conducted, including some that measured Viagra's effects on women. She broadcast the drug's potential benefits for women on 'Berman & Berman,' the Discovery Health cable-TV series that she co-hosted with her younger sister, sex therapist Laura Berman."
• "Less visible was another joint Berman endeavor, orchestrating media campaigns via satellite. 'You sit down in front of a camera in a sutdio and go on lots of news programs around the country, talking about the issue of the day or the public awareness issue you're promoting,' Laura says. For Procter & Gamble - which was hoping to market its own testosterone patch to increase female sexual desire - they heightened awareness of female libido issues. They discussed bladder health for Ocean Spray, herpes for Levitra, birth control for Seasonale and spotlighted other issues for Bayer and other clients. Jennifer didn't see any conflicts of interest with her scholarly work, because 'I was very careful not to endorse any particular product, just create awareness of a particular disease.'"
• "Jennifer says UCLA took a commission from fees earned from the TV show and media campaigns, which Laura says brought from $10,000 to $75,000 or more per day. Roxanne Yamaguchi Moster, media relations director for UCLA Health Sciences, says the university collected its 'standard overhead deduction ' of 12.5% for the Discovery Health show. "
• The Bermans promoted off-label use of Viagra for female sexual arousal difficulties on their website and on their "Berman & Berman" TV show. "'I thought it was just for men,' a guest on the show says. 'Well, you're gonna learn,' Jennifer responds, handing another woman 100 milligrams of Viagra and a vibrator and leaving her behind a partition with an erotic video while Jennifer measures her physical responses. Later in the show, Laura welcomes Hugh Hefner, 'the poster child for Viagra,' and a voice-over says: 'Thinking about trying Viagra? It's now available from your doctor in a free six-pill sample box.'"

Berman has her share of critics. Said Dr. Irwin Goldstein, "These people are into aromatherapy and media and message. [Jennifer] didn't want to be in our world. I presume her world is more lucrative." John Bancroft, a former director of the Kinsey Institute, said "There's been vigorous research in this field, almost all of it funded by the pharmaceutical industry, and I think it has ended up with having a bias toward medicalizing these problems. The Berman sisters have been quite succesful in getting into the media and bringing attention to themselves. I don't have a lot of respect for them scientifically.... They haven't let scientific evidence get in their way." And Leonore Tiefer from New York University School of Medicine said "Jennifer had some interesting scientific plans." Then, "this whole PR thing exploded. As sson as [the Bermans] got [to Los Angeles], I saw much more commercialization than research. It's a shame...."
Dr. Jennifer Berman eventually left the UCLA Health Center. "She attributed the 'weird undermining stuff happening' at UCLA partly to sexism in the male-dominated urology department and partly out of jealousy about her television appearances and cash-based medical practice."
Dr. Berman is opening up a new practice at the Rodeo Drive Women's Health Center. "She can't help but feel liberated. 'In the real world out here on Rodeo Drive,' she says, waving at the clothing stores, 'nobody knows from grants or papers, or for that matter cares. They want you to be respected and knowledgeable and a good doctor.'"
From someone who wonders whether Rodeo Drive is "the real world,".... This is a striking example of how pharmaceutical companies recruit physicians and academic health centers to promote awareness of ostensible health problems, for generous fees. The recipients of the cash may rationalize their participation as informing the public, and as not directly related to their research. However, the big issue is not whether such funding amounted to a conflict of interest for their research (although in my humble opinion, it clearly did.) The big issue is that unless all these marketing efforts were clearly identified as paid for and orchestrated by their pharmaceutical company sponsors, they were obviously deceptive.

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