Healthy Skepticism Library item: 20141

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

Toy M-A
Expert warns drug ads may make us a nation of hypochondriacs
The Age 2000 Aug 14

Full text:

Allowing drug companies to advertise prescription drugs directly to consumers would turn Australia into a “nation of healthy hypochondriacs”, a World Health Organisation adviser has warned.

Charles Medawar, a WHO drug policy adviser from Britain, told the National Medicine Symposium in Melbourne last week that an international push by the pharmaceutical industry to be allowed to advertise directly to consumers should be resisted.

Mr Medawar was part of a panel debating the issue, which is part of a national competition review being conducted by former VicHealth chief Rhonda Galbally.

The Review of Drugs, Poisons and Controlled Substances chaired by Ms Galbally is finalising an executive summary for the Council of Australian Governments, with the full report due to be released for public consultation next month.

Ms Galbally said yesterday that she was “yet to be convinced” the ban on direct to consumer advertising should be lifted.

Ms Galbally said she had fought throughout her career for consumer’s rights and said they deserved to know when new medicines were released. But drugs were not ordinary consumer goods and could not be treated as such, or “promoted as if they were lollies”.

Last Thursday’s debate at the National Medicine Symposium was organised by the National Prescribing Service, the government-funded, independent authority on the quality use of medicines, which opposes direct-to-consumer advertising.

The NPS issued a press release calling for a moratorium on the issue after the debate.

Panel member Alan Evans, chief executive officer of the Australian Pharmaceutical Manufacturers Association, argued on Thursday night that lifting the ban would enable consumers to participate in an improved “partnership” with their doctor to achieve the best health care.

Mr Evans said there was no difference between direct advertising to consumers and the public hearing about new drugs through the media.

Several panel members expressed concern about uncritical reporting of drug companies’ claims for new “wonder-drugs”.

Another panel member, Canadian public health academic and author Barbara Mintzes, said that in the United States, where advertising has been allowed since 1985, advertisements were often banned because drug companies were frequently found to have exaggerated the benefits – and minimised the risks – of their drugs.

Ms Mintzes said drug companies used emotive images to boost demand for their product and the results were often misleading.

Panel member and Canberra GP Peter Roush, who is also director of the National Prescribing Service, said patients’ emotional response to advertised products often led to the resulting consultation focusing on the product, rather than the best way of managing the patient’s health.

Dr Roush said if a doctor refused to prescribe the product, some patients would simply go to another doctor.

Mr Evans said people forgot that doctors and pharmacists were crucial gatekeepers – and so advertising was less harmful because a patient could not just go out and buy a new drug.

Mr Medawar said, in concluding the debate, that advertising was part of society’s “obsession with newness”, he was frightened at the speed with which the industry was pushing drug advertising and it would be an irreversible disaster if it were allowed.

Direct-to-consumer advertising is legal only in the US and New Zealand but is now under consideration in the European Union as well as Australia.

Participants in Thursday night’s debate also heard that the New Zealand Government was now reviewing the issue after controversy sparked by the emotive nature of some drug companies’ advertising campaigns.

Although direct-to-consumer advertising is not allowed in Australia, two recent television campaigns – for the anti-obesity drug Xenical, manufactured by Roche, and for Glaxo’s flu-drug Relenza – have sought to circumvent the ban by presenting them as “educational campaigns”.

The adverts do not mention the drug by name but urge sufferers to see their GP.

A discussion paper prepared by the National Prescribing Service says advertising can increase awareness of health problems and treatment options; can lessen the stigma of illness and disease; improves patient compliance and promotes prescribing in areas where there is under-prescribing.

The drug industry also argues that advertising would be more transparent than the present industry tactic of trying to persuade doctors and the media of the merits of new products.

The paper says the evidence to support these arguments is “very limited” but that evidence for the opposing side was also limited.

Those opposed to drug advertising argue that it will promote drugs over alternative therapies or lifestyle changes that may be more effective; could put pressure on the taxpayer-funded Pharmaceutical Benefits Scheme; and favor the big drug companies with large advertising budgets.

Opponents also argue that while people do need and deserve better information about medicines, the information vacuum should not be filled by advertising that emphasises efficacy and minimises side-effects.

But the paper says that while there seems little doubt that advertising is effective in publicising new medicines, its not clear whether this information improves medicine use or the health of patients.

The discussion paper concluded there was an overwhelming lack of information to properly inform the debate in Australia.