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Hearts, Minds, and Maladies: Toward a Critical Theory of the Commodification of Pharmaceuticals
Unformatted Document Text:  5 that tested and monitored products under the new food and drug regulations. For a drug to meet with AMA approval manufacturers could not make untrue advertising claims and had to fully disclose the drug’s properties. The AMA would not approve drugs that were advertised directly to the public and, to extend its autonomy over pharmaceuticals, approval was denied if the drug’s packaging or promotional material listed the maladies for which the drug was to be used. In short, drug companies were forced into a twin-tiered system for sales based on their choice of marketing strategy; drugs promoted and marketed to doctors could not be advertised to the public and drugs advertised to the layperson would not be approved (Starr 1984, pp. 131-132). Drugs were thus brought into the domain of professional practice, being prescribed and dispensed by physicians who also directly assessed the given condition. The AMA did not just reinforce the 1906 legislation, which was intended to work within market constraints and improve its functioning by making drug information more accurate. Rather, as historian Paul Starr puts it, “the logic of the AMA’s regulatory system was to withhold information from consumers and rechannel drug purchasing through physicians. This shift meant a structural change in the market rather than simply an improvement in its functioning” (p. 133). This extralegal regulatory apparatus remained stable and unchallenged for most of the 20 th century. The consumer movement of the 1930s led to the formal authority of the Food and Drug Administration (FDA) to disallow “false advertising” of any food, drug, or cosmetic, defining falsity as “creat[ing] a misleading impression ‘by ambiguity or inference’” (Stole 2001 p. 91). In 1938 the Food, Drugs, and Cosmetics Act was rewritten to better address false claims in advertising (Stole 2001; Mattelart 1990 p. 147). Yet alongside such formal administrative modifications American advertising during the 1920s and 1930s went through an

Authors: Tracy, James.
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5
that tested and monitored products under the new food and drug regulations.
For a drug to meet with AMA approval manufacturers could not make untrue
advertising claims and had to fully disclose the drug’s properties. The AMA
would not approve drugs that were advertised directly to the public and, to
extend its autonomy over pharmaceuticals, approval was denied if the drug’s
packaging or promotional material listed the maladies for which the drug was to
be used. In short, drug companies were forced into a twin-tiered system for sales
based on their choice of marketing strategy; drugs promoted and marketed to
doctors could not be advertised to the public and drugs advertised to the
layperson would not be approved (Starr 1984, pp. 131-132). Drugs were thus
brought into the domain of professional practice, being prescribed and dispensed
by physicians who also directly assessed the given condition. The AMA did not
just reinforce the 1906 legislation, which was intended to work within market
constraints and improve its functioning by making drug information more
accurate. Rather, as historian Paul Starr puts it, “the logic of the AMA’s
regulatory system was to withhold information from consumers and rechannel
drug purchasing through physicians. This shift meant a structural change in the
market rather than simply an improvement in its functioning” (p. 133). This
extralegal regulatory apparatus remained stable and unchallenged for most of
the 20
th
century.
The consumer movement of the 1930s led to the formal authority of the
Food and Drug Administration (FDA) to disallow “false advertising” of any
food, drug, or cosmetic, defining falsity as “creat[ing] a misleading impression
‘by ambiguity or inference’” (Stole 2001 p. 91). In 1938 the Food, Drugs, and
Cosmetics Act was rewritten to better address false claims in advertising (Stole
2001; Mattelart 1990 p. 147). Yet alongside such formal administrative
modifications American advertising during the 1920s and 1930s went through an


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