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Healthy Skepticism Library item: 19678

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: news

Hanrahan C
Dismay at drug company push for govt subsidy
Medical Observer 2011 Nov 1

Full text:

A DRUG company push to enlist doctors and patients into pressuring the federal government to subsidise the warfarin alternative dabigatran has been branded “appalling” and “inappropriate”.
AN open letter from dabigatran (Pradaxa) manufacturer Boehringer Ingelheim (BI) published in medical newspapers this week urges GPs to petition the government via a website , Vote Against Stroke.

Similar unbranded communications targeted to consumers were planned, a company spokesperson said.

Dr Evan Ackermann, chair of the RACGP’s national standing committee on quality care, said the campaign represented “appalling behaviour”.

“I think it’s quite inappropriate to drum up support, whether it’s within the public [domain] or within the doctors’ group, to pressure the [government] into doing this sort of thing,” Dr Ackermann said.

Professor Simon Chapman, from the University of Sydney’s school of public health, said BI’s tactics were “really inappropriate”.

“There are only two countries in the world where they allow direct-to-consumer advertising to try and put consumer demand on their prescribing of drugs and that’s the US and NZ,” Professor Chapman said.

“Australia takes the view that there is far too much at stake to throw regulation, or the demand for drugs, over to just market forces like this.”

A company spokesperson said they had made every effort to stay within the Medicines Australia code and the campaign was their only option to make sure patients with atrial fibrillation (AF) were treated and protected.

The campaign website due to go live on 2 November will state the government must accept responsibility for the 15 strokes a day that will occur because dabigatran has been deferred from PBS listing.

The figure was based on a Deloitte Access Economics analysis commissioned by BI, which an independent expert criticised as flawed.

Professor Amanda Thrift, head of the epidemiology and prevention division in stroke and ageing research at Monash University, told MO the analysis omitted recent data from a Perth study showing the rate of strokes decreased by 5.5% per annum between 1989 and 2001.

“It’s a lot over a 10-year period, so really the number of strokes is likely to be vastly overestimated,” Professor Thrift said.

A BI spokesperson said the data on stroke numbers matched those quoted in a national stroke audit conducted by the Stroke Foundation and released last week.

Dabigatran received a non-valvular AF indication in April this year, but last month Health Minister Nicola Roxon delayed its PBS listing, instead announcing a review of all anticoagulation therapies. The PBAC had advised the drug may become overprescribed.


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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963