Market analyses on pharmaceutical products, based on in-depth psychology, continue to be of prime importance even in times of “big” or “smart” data. After all, drug prescription and usage is influenced not only by conscious but also by unconscious emotional mechanisms and mental images, which regulate management of the disease, medical treatment and the use of pharmaceutical drugs. Therefore, treatment cultures are a relevant psychological context for pharmaceutical market research.
What are “treatment cultures”?
Treatment cultures are holistic, transpersonal, cultural forms of regulation. They govern the experience and behaviour of all those involved. Doctors, patients and relatives get caught up in this as well as – in a conducive or sometimes obstructive fashion – the health system and medications. The impact of the treatment culture is mostly not even noticed which is why in-depth psychological explorations are necessary.
An example: In the western world, the development of medical procedures may have progressed a long way, but the images, attitudes and therapeutic forms to arise centuries ago still have a strong influence. Take for example the belief in higher (religious) powers that decide on “sick” or “healthy”, or the belief in naturopathy which, despite many critical objections, has regained its appeal.
In our psychological pharmaceutical market research it is regularly shown that treatment cultures, independent of the medical manifestation of a disease, are very frequently also shaped by irrational factors. These have nothing or only little to do with the healing routines specified by evidence-based medicine. By this we mean the psychological dramaturgy accompanying the disease for the patients and doctors.
An example: heart problems lead to the partly suppressed but often vehement fear of having to die. This results in resolutions to change the lifestyle because it is simply a matter of life and death. However, the consequence may be that the patient obediently does a bit more sport and smokes less but at the same time does not abstain from drinking alcohol or regularly eating (too) fatty food.
The doctor plays a decisive role in the treatment culture, which can alternate between different positions depending on the patient’s condition. In heart patients, for instance, the doctor can change between the position as admonisher, educator or saviour in the hour of need, etc. Related recommendations as well as diagnostic and treatment activities likewise change depending on the doctor’s role.
Looking at everyday reality based on a specific group of drugs – here based on the example of lipid-lowering drugs for hypercholesterolemia – it is possible to observe a co-existence of rational medical statutes and unconsciously active images. It is a matter of treating a disease which the patient does not feel but which can hold a high risk of myocardial infarction or stroke. The disease involves many uncertainties for doctor and patient alike.
The image of an “invisible sword of Damocles” hanging over the patient is psychologically active in this case. Whether a disease exists at all and its severity is defined by guidelines for certain lipid levels. Therefore, hypercholesterolemia is initially a “laboratory disease” for many doctors. Lipid-lowering drugs are not taken so the patient feels better but so that laboratory lipid levels are in the target range.
The doctors like to prescribe effective and expensive drugs to those patients who “cooperate”, who keep to the recommended lifestyle changes and who regularly take their medication. In short, unconscious old images of obedience, control and punishment take effect here.
It is first the look through the “in-depth psychological microscope” that allows precisely these complex tensions in dealing with indications and drugs to be identified. In the end, this knowledge is a decisive factor for successful strategic and operational marketing given that, from a psychological perspective, pharmaceutical products have to be regarded as embedded in the treatment culture. Accordingly, a pharmaceutical product is not only distinguished by its actual efficacy but also by the further unconscious, psychological promises it has to meet.
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