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Eliminating Stigma: A consideration of the role the pharmaceutical industry can play

My recent article in Medical Marketing & Media explored the importance of vaccine perceptions in a self-pay market and touched upon the issue of stigma, with the recognition that some diseases or conditions are so taboo in society that for physicians to merely suggest the idea of vaccination to their patients is to risk casting aspersions on their lifestyle. In this blog , I aim to take a more in-depth look at what stigma means in the context of healthcare and consider the opportunities and challenges for pharma.

Let's start with a definition: the Oxford English Dictionary defines ‘stigma’ as ‘a mark of disgrace associated with a particular circumstance, quality, or person’. Etymologically, the word dates back to the Greek, literally meaning 'to brand or tattoo', having acquired its figurative meaning in the 17th century.  

As specialists in healthcare, stigma is something we frequently encounter across many of the disease areas in which we work. This is most evident when we are conducting research directly with patients and particularly in the emerging markets, which is my team’s focus.  From sexually transmitted diseases to mental illness, shame may be associated with their condition and is a devastating reality for many of the patients we seek to understand. 

At one level, stigma creates logistical challenges for us as market researchers. Recruiting and engaging patients with ‘unmentionable’ diseases to take part in market research interviews requires a creative approach and sensitive handling. For example in countries such as Saudi Arabia and Singapore, trying to recruit HIV patients is a challenge when disclosing one's status as HIV positive has legal implications.  

Of course stigma presents a challenge for pharmaceutical companies too. Patients who are too afraid to be tested, declare their status or seek help for their symptoms from a healthcare professional are unlikely to end up on effective treatment. Even if they do, stigma may considerably delay matters. As with the vaccination example mentioned earlier, stigma is also a potential impediment to prevention efforts. 

The involvement of the pharmaceutical industry in campaigns to reduce the stigma of certain diseases / conditions is nothing new. The US National Alliance on Mental Illness (NAMI) campaign to end discrimination against mental illness was heavily funded by a number of major pharmaceutical companies. Some commentators view such industry campaigns with cynicism, particularly in the more ambiguously defined and less clear cut therapy areas such as mental health. Making a label or diagnosis more ‘socially acceptable’ can be argued to be neither preventative nor curative but causative, i.e. done for the sole purpose of selling more people more drugs they don't need.
Pharmaceutical marketing materials have also been accused of perpetuating stigma. A 2010 literature review published in the Journal of Mental Health found that advertisements for psychiatric medication were more likely to include negative imagery and less likely to portray people in everyday situations.

However that is not to say that pharmaceutical industry activities cannot be helpful, and in many areas there is clear opportunity (and need) for activities designed to reduce the stigma associated with illness. Putting this into practice is often far from easy, as intangible perceptions are difficult to alter. In some markets, stigma is deeply rooted in culture or religion, for example in conditions where possible routes of transmission include activities considered ‘sinful’. Ignorance is however often a key contributory factor in stigma. For example in conditions with visible manifestations such as psoriasis or shingles, frequently and incorrectly thought to be contagious, educational activities designed to raise public awareness of the condition can improve patients’ lives.    

In conclusion, stigma is an important aspect of living with many health problems, and one that needs to be considered when conducting market research, particularly when patients are directly involved. A more in-depth understanding of the prejudice patients may face in their daily lives is also critical in helping to design activities and campaigns to address their needs, and to ensure implicit discriminations are not perpetuated in communications. 

Research Partnership is one of the largest independent healthcare market research and consulting agencies in the world. Trusted partner to the global pharmaceutical industry, we use our expertise and experience to deliver intelligent, tailor-made solutions. We provide strategic recommendations that go beyond research, helping our clients to answer their fundamental business challenges. Find out more here:

2nd April 2015


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