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Healthy Skepticism Library item: 20123

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

Reguly E
Battle brews over Canadian drug ads
The Globe and Mail 1999 Oct 30B2

Full text:

Flip through an American magazine and you will find all sorts of ads for prescription drugs, ranging from the familiar – Viagra – to obscure medicines for arthritis, asthma and others. Flip through a Canadian magazine and you will find nothing of the like.

Ads for prescription medicines do not appear in the Canadian media for the simple reason that they were banned by the Food and Drugs Act half a century ago to “protect the purchasing consumer against injury to health and against deception…” Since then, the Charter of Rights and Freedoms has been written and it guarantees freedom of expression, which presumably includes commercial free speech. A lobby group that no one has every heard of, called the Alliance for Access to Medical Information, may use the Charter to challenge to advertising ban.

Alliance members have been busy working Health Canada’s back corridors to get the ban lifted. They don’t want to talk about their effort – “things are at a delicate stage”, one of the Alliance people says – but won’t say why. Here’s a guess. The provincial health ministries are dead set against prescription drug advertising and the last thing federal Health Minister Allan Rock needs is another epic battle with his provincial counterparts. The Alliance could be dealt a potentially fatal backlash if its lobbying effort were made public.

If you thought the Alliance is comprised of honourable liberals who think all forms of censorship are evil, you’d be wrong. To the Alliance, the issue is not so much freedom of speech as freedom to make more money. The group is made up of media and advertising groups such as Maclean Hunter, publisher of Maclean’s magazine, and the Institute for Canadian Advertising. You may remember some of the Alliance’s media members from the last great advertising war, when freedom of speech was not exactly high on their agendas. Then, they wanted to make it illegal for Canadian companies to place ads in Canadian editions of American magazines. But that’s another story.

The Alliance sees a potentially rich new source of income for ad agencies and their media clients, which live or die on the amount of ads they take in. In the United States, prescription drug advertising is thought to be worth about $1.5-billion (US) a year. Using the standard one-tenth rule, this would translate into a $150-million market in Canada – if it were allowed.

The Alliance’s incentive to win becomes all the more compelling because cigarette ads are gone and booze ads are dwindling as aging boomers get there kicks from double-lattes instead of gin martinis. In the late 1980’s, Maclean’s took in about $9-million a year in liquor ads; the figure has since dipped to less than $1-million. The other reason to get drug ads is to level the playing field with the United States. American magazines account for about 80 percent of newsstand sales in Canada and about 50 percent of overall sales.

You would not, of course, find any discussion of the income potential of drug ads from the Alliance literature. A draft press release from April, never published, refers to itself as a “growing group of Canadians dedicated to helping Canadians get access to medical therapies”. It then presents a barrage of statistics that purport to show that Canadians are yearning to see prescription drug ads and want to “take control of their own health” by learning about new drugs. It even claims that drug ads could reduce healthcare costs because “patients who are actively involved in their health decisions are more likely to comply with their therapies”. Such is the power of advertising. Apparently, consumers are more willing to take instruction from an ad in People magazine then from a doctor.

Where the media and advertising agencies see profits, the provincial health ministries see costs. They fear that direct-to-consumer advertising, as they call it, will put more pressure on a system that is already close to breaking down. The fear is that consumers will spot an ad for, say, a new toe fungus cure and rush to their doctor with demands for a prescription. Seeing, the doctor is the first extra cost. The second is the drug itself, which may cost a fortune.

The health ministries are also concerned that drug ads will lie by omission. They may not, for example, talk about possible side effects or exaggerate the drug’s benefits. The ads certainly would not mention that cheapie generic or non-prescription drugs could treat the same ailment just as effectively. European countries have similar concerns. The United States and New Zealand are, in fact, the only countries that allow prescription-drug ads.

Canada is different. Since Canada is dominated by American media and the Internet, which all carry drug advertising, it seems absurd that the same ads should be banned from the few Canadian media outlets that remain. The debate should not about whether drug ads should be allowed, but under what conditions they should be allowed. Tight regulation to keep the ads honest is the answer.


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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963