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Healthy Skepticism Library item: 19762

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

Mansfield P
Sickening sales pitch of the drug marketeers
The Sydney Morning Herald 2000 July 3


Author: Peter Mansfield, Dr Peter Mansfield is an Adelaide GP and director of the Medical Lobby for Appropriate Marketing (MaLAM).

Full text:

Allowing drug companies to hawk their wares direct to the public is a major health risk.

WILL drug advertising harm you? Around the world, multinational drug companies are lobbying governments to weaken the regulations on direct-to-consumer advertising of prescription-only drugs (DTCA).

Previously drug companies in Australia were allowed to aim their advertising only at doctors. But they have recently started advertising prescription drugs direct to the public, using a loophole in the law that allows them to highlight the disease as long as they don’t name the drug.

For example, there has been television advertising of a new weight-loss drug for obesity. The drug companies want to be able to name the drug so that people will be able to demand it from their doctors by name. As a doctor, I fear that this practice would be a major threat to health.

The drug companies want Australia to be as permissive as the United States and New Zealand, which have the weakest laws in the Western world because the possibility of DTCA was never considered when their legislation was written.

In the US, spending on DTCA soared by 40 per cent to $US1.8 billion last year because the companies have discovered that such advertising produces massive growth in sales of drugs. The costs have been passed on to the customers, without them knowing.

In Australia the cost of the Pharmaceutical Benefits Scheme is already growing out of control. DTCA is a further threat to the hip pocket of every taxpayer, especially those with health problems.

To make good decisions about the use of medicines people need balanced, reliable information about the probabilities of benefit and harm from all the alternatives. Drug companies claim that DTCA provides the information that people need. However, many studies have shown that people gain little information from drug advertisements.

There are no incentives for companies to provide clear warnings about adverse effects, let alone to inform the public about the advantages of cheaper drugs or non-drug therapies.

Advertising does not educate, it persuades. Advertising uses conscious and subconscious appeals to the head and to the heart which have been developed over thousands of years since rhetoric was invented by the ancient Greeks. The science behind advertising is better-funded and more advanced than medical science.

DTCA uses sophisticated emotional manipulation to get patients to decide to demand a drug without hearing the other side of the story. Studies of doctors show that the more we rely on drug company promotion, the more mistakes we make. Some patients are more able than their doctors to view this manipulation with scepticism, but many are not. Promotion may not fool all of the people all of the time, but it does fool the more vulnerable.

Drug companies claim that doctors will protect people from prescription drugs that are harmful. However, people can bypass doctors and get drugs from friends, family and the Internet.

The adverse consequences are not felt only by patients, but also by doctors.

Many New Zealand doctors have told me about their distress at having to cope with patients who demand inappropriate drugs. Studies show many doctors cave in to pressure from patients despite knowing that what they are asking for is not in their best interests. This happens because most doctors want to please people.

We doctors already have a high death rate because our work is so stressful.

More DTCA would make things even worse.

The drug companies know that DTCA is likely to be banned in New Zealand soon because the country’s Health Minister, Annette King, is no fool. Consequently, there has been some desperate lobbying in Wellington in recent weeks.

In June, the association for foreign drug companies, the Researched Medicines Industry in New Zealand, used the advertising of the virility drug Viagra as an example of the benefits of DTCA.

Many men have occasional ``equipment failure” that would come good with reassurance. By contrast, current ads directed at consumers to promote Viagra in New Zealand seek to frighten men into thinking that if they don’t use the drug their wives will leave them. This is not supported by the research on why relationships succeed or fail. Viagra does benefit many, but can also kill. The advertisement does not provide the clear warnings that are needed to prevent deaths.

If the use of fear to promote Viagra is the best evidence in favour of DTCA that the drug companies can come up with, then we would be better off getting information from less biased sources.

The reason that drug companies can’t be trusted to provide reliable information about their products is not because they are bad. The problem is that the system rewards drug companies for increasing sales, regardless of the impact on health.

Consequently, company staff have little choice but to do what works to increase sales or to lose their well-paid jobs.

One method used to promote this mentality is ``groupthink”, where staff reinforce each others’ false beliefs that their drugs really are superior and under-used.

We need to find ways to pay drug companies more for doing the right thing than for doing the wrong thing.

For example, they can be required to sign capped annual contracts which reward them for selling only so much of their product no more, no less.

That will not be easy but it is a possibility for the future.

Meanwhile, the regulations on DTCA should be strengthened.


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