Marketing Myth: One-Dose-Fits-All

Maartje van Caspel

Drug makers are motivated to do as little as required for the patients who use their medications.

“It’s the holy grail that every drug company tries to achieve,” according to a former director of the FDA's Center for Drug Evaluation and Research. “One-dose-fits-all is a marketing myth.”

We are all different and when given the same dose of the same drug, our responses vary greatly. The medical term for this is “individual variation,” and according to AMA Drug Evaluations, our variations can range from 400 to 4,000 percent!

“To think the same dose will do the same thing to all patients is absurd.”

—Dr. Raymond Woosley, chairman of the department of pharmacology at Georgetown University

ABOVE: Gebhart, F. “Is standard dosing to blame for adverse drug reactions?” Drug Therapy, Jan. 17, 2000, 34; as cited in: Cohen, J.S. Over Dose. New York: Penguin Putnam Inc., 2001.

And yet, two very different people, a 65-year-old man with several medical disorders and a healthy 25-year-old may receive the same dose of the same drug. Why do drug-makers create so few dosage options for millions of widely-different patients?

Pharmaceutical companies are in business to make healthy profits. Billions and billions. And they cannot enrich their shareholders unless doctors write millions of prescriptions for their brand-drugs. So drug-makers seek to make prescribing easy by producing simplistic (and therefore unnecessarily high) doses.

“Limited doses are quicker and easier to research, cheaper to produce, and easier to market, requiring fewer guidelines and fewer pill sizes,” writes Jay S. Cohen, M.D., associate professor of family and preventative medicine at the University of California at San Diego, in his book, Over Dose: The Case Against the Drug Companies. Dr. Cohen learned from a medical expert who performs studies for drug companies that pharmaceutical “salespeople do not want to sell drugs that have to be tritated [slow and gradual dosaging] or individualized.” The drug marketers “have almost demanded a single pill strength and a single dose for all patients.”

More than 180,000 American patients die every year from taking their medications.

—Journal of the American Medical Association

ABOVE: Lazarou J., et al. “Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies.” JAMA 279 (1998):1200-1205.

Easy-to-use, often one-size-fits-all initial doses, solve the problem for doctors who are already under overwhelming pressure to work fast. “Doctors who take their time with patients only only make less money, but some also get harassed by administrators or partners for not packing in more patients by keeping the interactions brief.” Dr. Cohen continues. “But simplistic, easy-to-use, unnecessarily high doses don't work for patients. These methods expose people to unnecessary, avoidable risks. The result is an epidemic of millions of side effects and thousands of deaths each year.”

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