Illuminating the techniques used in drug advertisements
Healthy Skepticism AdWatch Index Introduction

Please note this AdWatch issue is no longer active so you can not submit answers to the questions below.

Australia April 2004

Sir Tom McKillop
Chief Executive
AstraZeneca

Dear Sir Tom,

Healthy Skepticism Inc is an international organisation that aims to improve health by reducing harm from misleading drug promotion.

You may find some of the recent publications in major medical journals, that we contributed to, useful for evaluating the quality of our work.[1],[2],[3],[4],[5]

We launched AdWatch for Australian general practice last year.[6],[7]  AdWatch aims to illuminate the techniques used in drug advertising.  We will also use feedback from AdWatch participants as a basis for dialogue with the companies responsible for the advertisements, self-regulatory systems and the government regulatory agencies.

The first topic for AdWatch is the advertising of Nexium in Australia.

We have now had extensive consultation with some of your staff and with AdWatch participants.  AdWatch participants are a volunteer sample of health professionals who represent a range of views including a market segment of healthy skeptics that is becoming larger and more influential.  To the extent that the healthy skeptic’s market segment grows your company’s future will depend on learning how to respond to us.

Your company’s Nexium advertising targeting Australian GPs is open to the interpretation that Nexium 40mg is the best choice for all cases of gastro-oesophageal disease because of a clinically worthwhile effectiveness advantage (“Nexium 40mg offers greater healing power”).  However Nexium 40mg daily is not an appropriate treatment for most cases of gastro-oesophageal disease that are commonly seen by GPs because, for non-severe cases, it has no clinically worthwhile advantages and is more expensive.  Nexium 40mg may have a place for more severe disease but this is unclear because the evidence available is contradictory.[8],[9]

We hope that you will agree that if doctors have developed incorrect impressions about a drug as a result of your advertising then measures should be taken to correct those impressions.  Therefore we would like to work with your staff to develop a new set of advertisements that would run until surveys of doctors show that any mistaken beliefs have been corrected.

If you are willing to have your staff work with us then please let us know within two weeks. 

Please find below links to the AdWatch new topic and feed back issues and the raw feedback from AdWatch participants who gave permission as well as correspondence with your staff.

Yours sincerely,

Dr Peter R Mansfield
Director, Healthy Skepticism Inc
Editor, Healthy Skepticism AdWatch

Reply to AstraZeneca's "Nexium experts" from the AdWatch team April 2004

Response from AstraZeneca's "Nexium experts" to AdWatch on Nexium December 2003

Peter Mansfield to Paul Woods April 2004

Paul Woods to Peter Mansfield December 2003

Raw Feedback from AdWatch participants who gave permission

Feedback about AdWatch on Nexium December 2003

Correspondence between Peter Mansfield (Healthy Skepticism) and Paul Woods and Mike Bull (AstraZeneca) July to November 2003

AdWatch on Nexium October 2003

Opportunity for further comment

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[1] Rogers WA, Mansfield PR, Braunack-Mayer AJ, Jureidini JN. The ethics of pharmaceutical industry relationships with medical students. Med J Aust. 2004 Apr 19;180(8):411-4.

[2] Mansfield P, Henry D, Tonkin A. Single-enantiomer drugs : elegant science, disappointing effects. Clin Pharmacokinet. 2004;43(5):287-90.

[3] Jureidini JN, Doecke CJ, Mansfield PR, Haby MM, Menkes DB, Tonkin AL. Efficacy and safety of antidepressants for children and adolescents. Brit Med J 2004;328:879-83

[4] Svensson S, Mansfield PR. Escitalopram: superior to citalopram or a chiral chimera? Psychother Psychosom. 2004 Jan-Feb;73(1):10-6.

[5] Jureidini J, Mansfield P, Menkes D. The statin wars. Lancet 2003 Nov 29; 362(9395)1854

[6] Melissa Sweet. Website launched to expose "tricks" of drug ads. BMJ 2003;327:936

[7] Mansfield PR. Healthy Skepticism’s new AdWatch: understanding drug promotion. Med J Aust 2003; 179 (11/12): 644-645

[8] Scholten T, Gatz G, Hole U. Once-daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD-related symptoms. Aliment Pharmacol Ther. 2003 Sep 15;18(6):587-94.

[9] Labenz J on behalf of the EXPO study group, Keeling N, Eklund S. A comparison of esomeprazole 40 mg once-dail and pantoprazole 40 mg once-daily for the healing of reflux esophagitis. Gut 2003;52 Suppl VI:A241.

 

AdWatch is produced by Healthy Skepticism:  www.healthyskepticism.org
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