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A Quiz for Drug Companies

When online quizzes are not as private as we imagine.

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The New York Times reports today that RealAge, the company that promises to make us look younger, has been caught selling patient information to drug companies, including the manufacturers of some of our most popular antidepressants and anti-anxiety medication. As the Times puts it, the company has been acting as a "clearinghouse" for large corporations such as Pfizer, Novartis, and GlaxoSmithKline. And you thought the wrinkles were going to disappear.

Where to begin with this one? First, the questionnaire asks a lot of highly personal information—way too much, given where the data end up. Then you've got the issue of patient confidentiality and drug companies sending prospective patients information apparently suited to their profile and possible health concerns. All of which is designed to encourage them to "ask their doctor if X or Y is right" for them.

A few other issues arise, too. Ever since the FDA, in 1997, "relaxed its rules on pharmaceutical advertising to let the pharmaceutical industry bypass healthcare providers," the latter, as Senator Grassley is now investigating, has spent millions—make that now billions—advertising such products directly to us. In 1996, the total amount spent by big pharma on advertising was $595 million. "Within a year," Beth Hawkins reports in City Pages, "spending [had risen] to $843 million. By the year 2000, the amount had shot up to nearly $2.5 billion." Today, the same companies put a cool $3 billion a year toward "direct-to-consumer" advertising. That's almost $10 million a day.

When I read such news, I can't help but think of "SPIN," the perhaps justly named questionnaire for gauging when shyness becomes social anxiety disorder (it was called a "Social Phobia Inventory"). It asked clients to rate, on a scale of 1 to 4, their reaction to statements that might strike us as more everyday than typifying a really serious psychiatric disorder: "Being criticized scares me a lot." "I avoid going to parties." "I avoid speaking to anyone in authority."

I too don't relish the thought of speaking to people in authority; lots of us don't. Is that beside the point or, perhaps, the point in question?

I know it's asking a lot to suggest that a pharmaceutical company behave ethically, but this kind of deception has to be exposed if it is to end. It goes on far too much behind the scenes and under the radar. It's a serious breach of public trust, and it has the added (and unfortunate) consequence of making too many people believe their problems simply require drug-related treatment. Quite often, they don't.

Christopher Lane, the Pearce Miller Research Professor at Northwestern University, is the author most recently of Shyness: How Normal Behavior Became a Sickness. Follow him on Twitter @christophlane

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