In a damning report, the Consumers International (CI) lobby group called on more transparency, demanding that drug makers be held more accountable for it's marketing methods.
In 2005 total global pharmaceutical sales grew 7 per cent at constant exchange rates, to $602 bn (€480bn). The report identified an annual marketing spend of $60bn (€47bn).
The figures represents an annual marketing budget of nearly twice that of research and development costs and puts into context the importance marketing and promotion play in the drug's life cycle.
The study saved its biggest attack on new marketing tactics that it claims are using "alternate pressure points to doctors, such as patient groups, medical students and pharmacists, coupled with new tactics, particularly using internet chat groups and drug or disease information websites, to market their products."
Other techniques described involved providing health and illness information via pamphlets, magazine articles etc, without the company actually promoting a specific product directly to the consumer or health practitioner.
Currently in Europe, EU legislation does not permit the marketing of prescription drugs to consumers directly.
"The absence of clear marketing policies for these companies is remarkable, given that irresponsible marketing practices form a serious, persistent and widespread problem among the entire pharmaceutical industry," the report said.
"This lack of commitment to adhere to internationally accepted standards of ethical corporate behaviour at the company level raises serious doubts about the strength of industry self-regulation," it added.
The approach pharmaceutical companies are taking to the promotion of its treatments could be seen as foolish, especially as pharma are only just recovering from the fallout of the Vioxx episode.
In September 2004, Merck announced a voluntary withdrawal of its blockbuster drug Vioxx from the market due to concerns of an increased user risk of cardiovascular problems including heart attack and stroke.
As a result, over 6,000 lawsuits were filed in the US and elsewhere by people claiming that they or their family members had suffered heart attacks as a result of taking Vioxx. Subsequently, it was revealed that Merck had known about the risks associated with Vioxx as early as 2000.
Furthermore, the company was accused of manipulating a study in The New England Journal of Medicines, whereby researchers who were sponsored by Merck deliberately erased a table with information about cardiovascular effects before sending it for publication.
During the lawsuits two medical professionals testified that they were pressured by Merck not to publish test results that showed increased rates of cardiovascular disease.
In early 2005 a study calculated that Vioxx caused between 88 000 and 140 000 cases of heart disease in the US.
The report also found breaches of regulations and CSR codes occurred frequency. Large numbers of serious, recent and repeated breaches of marketing codes were found, especially regarding prescription drug advertising.
"The current regulatory framework is clearly insufficient to prevent systemic violations of marketing regulations, and to ensure the highest possible level of consumer protection," the report said.
The CI called for governments and the pharmaceutical industry to act immediately to address the "persistent roadblocks to consumer sensitive and socially responsible drug promotion."
A copy of the report can be viewed >here.