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Transcultural Psychiatry
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`Consumers are Patients!' Shared Decision-making and Treatment Non-compliance as Business Opportunity

Kalman Applbaum

University of Wisconsin at Milwaukee, applbaum{at}uwm.edu

This article describes an aspect of the progressive insertion of commercial interests into the relationship between patients and their clinicians, with particular reference to psychiatry. Treatment noncompliance, a long-standing problem for healthcare professionals, has lately drawn the attention of the pharmaceutical and allied industries as a site at which to improve return on investment (ROI). Newly founded corporate `compliance departments' and specialized consultancies that regard noncompliance as a form of marketing failure are seeking to rectify it with reinvigorated models and strategies. This intervention stands to impact patients' experience of illness as well as the participation of those formally (physicians, case managers, etc.) and informally (family, friends, etc.) involved in treatment. My analysis draws upon observation at compliance conferences to demonstrate the contrasting models of patient empowerment underlying the marketing vs. medical approaches. I propose a research agenda for measuring the effects of industry compliance programs.

Key Words: marketing • medical commercialization • psychopharmaceuticals • treatment non-compliance

Transcultural Psychiatry, Vol. 46, No. 1, 107-130 (2009)
DOI: 10.1177/1363461509102290
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