(Eichacker, Natanson, and Danner 2006) Surviving Sepsis

Eichacker, Peter Q.; Natanson, Charles; Danner, Robert L. Surviving Sepsis—practice guidelines, marketing campaigns, and Eli Lilly. New England Journal of Medicine. 2006 Oct 19; 355(16):1640–1642.

Eichacker, Natanson, and Danner describe “the intrusion of marketing strategies masquerading as evidence-based medicine” in the development of clinical guidelines for the treatment of sepsis (infection, often blood infection, leading to organ malfunction or whole-body symptoms such as a severe drop in blood pressure). Drugmaker Eli Lilly, working through the PR firm Belsito, spent millions of dollars on a disguised marketing campaign for its sepsis medication Xigris (drotrecogin alfa, or recombinant human activated protein C—rhAPC). The campaign included a grant to a group of physicians and bioethicists to form the Values, Ethics, and Rationing in Critical Care (VERICC) Task Force, ostensibly to address ethical dilemmas related to rationing of scarce medications in critical care. At the same time, Belsito spread rumors that rhAPC would be rationed. The campaign also included a purported public health campaign to increase public awareness of sepsis and motivate the creation of formal clinical guidelines for its treatment, the Surviving Sepsis Campaign. Belsito was successful in bringing about the adoption of guidelines that featured the use of rhAPC prominently, and their endorsement by eleven professional societies. The Infectious Diseases Society of America (IDSA), however, declined to endorse these guidelines.


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