Healthy Skepticism Library item: 14423

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Rutter P, Gilbody S.
The European pharmaceutical industry: coming to a screen near you?
J R Soc Med 2008; 101:(10):485–488.
http://jrsm.rsmjournals.com/cgi/content/full/101/10/485

Abstract:

The European Commission Pharmaceuticals Unit
is currently developing a legal proposal to increase
the public provision of information about prescription
medicines. Their preliminary proposal would
achieve this by permitting pharmaceutical
companies to provide unsolicited information
about their prescription-only products directly to
the public via the mass-media.1 The permitted
channels of dissemination would include television,
radio and print media, as well as standalone
products distributed directly or via healthcare
professionals. The stated intention of this
controversial proposal is to meet a public need
for high quality, reliable information about
medications.

Legislative debate in this area is not new. In
2002, the European Parliament debated a proposed
five-year pilot scheme of mass-media advertising
limited to drugs for diabetes, asthma and
AIDS. The proposal was rejected by 494 votes to
42.2 Currently, the USA and New Zealand are the
only developed countries that permit direct-toconsumer
advertising (DTCA) of prescriptiononly
medications; it is a contentious issue in
both.3,4

The preliminary proposal insists that our ban
on advertising should be maintained, instead forwarding
a suggestion that the pharmaceutical industry
be able to disseminate ‘non-promotional
information’. Herein lies the conundrum, as the
distinction between ‘advertising’ and massprovision
of unsolicited information by industry is
not immediately obvious. Indeed, despite widespread
agreement that such a distinction is absolutely
crucial to the current proposal, neither the
proposer nor any stakeholder has yet offered a
clear means to achieve this.5 Opponents therefore
fear that permitting such legislation would be tantamount
to allowing advertising in all but name.6
The importance of this debate cannot be underestimated:
widespread information dissemination
has the potential to significantly impact the public’s
understanding of health, disease and medications,
and to alter the nature of the doctor-patient
relationship. Whilst this debate may be relatively
new to Europeans, it is both long-standing and
familiar in North America and Australasia. We are
therefore fortunate to have the benefit of others’
experiences. Indeed, we are urged to learn from
these experiences by physicians in New Zealand.
They fear that Europe’s current trajectory represents
a ‘slippery slope’ to their own situation in
which drug advertising is omnipresent, though
unpopular with doctors and with patient groups.7
Within this article we draw on international
experience to contextualize and consider the potential
European policy. We summarize the discourse
that surrounds DTCA in the USA and New
Zealand and present a taxonomic framework.
Starting from a discussion of Canada’s experience,
we discuss the distinction between information
and advertising. We consider how Europe could
draw all of this together to carve its own path
towards world-class provision of patient-centred
information.