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Healthy Skepticism Library item: 20147

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: Magazine

Sweet M
Getting to the consumer direct
Australian Doctor 1999 Mar 529

Full text:

You may have seen them. The faceless men in boxer shorts whose photographs were plastered across the media late last year under the heading “52% of men aged 40-70 have one thing in common. Erectile problems. See your family doctor about treatment options that are now available”.

Some of the advertisements carried a large red V.

What did you immediately think of? Hope it wasn’t Viagra. According to the advertising agency and the company which paid for the ads, Pfizer, these were not ads for Viagra, but were merely aimed at raising awareness of erectile dysfunction.

They insist, with straight faces, that the V was for victory. Of course. It will be interesting to see the Australian Pharmaceutical Manufacturers Association (APMA) code of conduct committee’s verdict on a complaint before it alleging the advertisements were in breach of the industry code for marketing prescription products.

The code emphasises that such products should be promoted only to healthcare professionals: “Any activity directed toward the general public which encourages a patient to seek a prescription for a specific prescription-only product is unacceptable”.

But the code is often circumvented by industry promotions, including through the general news media. For some examples, have a read of Ray Moynihan’s new book, ‘Too Much Medicine?’, which was warmly reviewed in the British Medical Journal recently.

If there’s so much indirect promotion going on already, with consumers perhaps not realising that news items are sometimes little more than disguised ads, wouldn’t it be better to get it all out into the open and allow prescription medicine to be advertised to the public? It already happens in New Zealand.

Perhaps this would encourage a greater transparency into the process by making it easier to assess where information is coming from, and why.

Direct-to-consumer (DTC) advertising, as the jargon goes, is booming in the US, where the industry spent $US917 million ($A1.432 billion) in 1997 on consumer advertising. This was a jump of 46% from the previous year.

In a recent article in the Journal of the American Medical Association, the president of Pharmaceutical Research and Manufacturers of America, Alan Holmer, wrote enthuastically of the benefits of DTC in improving public health by educating consumers and empowering them to take more responsibility.

He cited a survey estimating that DTC has encouraged 21.2 million US consumers to talk with their doctor about a medical condition or illness they had never talked with their doctor about before seeing an advertisement.

Should this be the way of our future? Drug wars on TV for better public health?

For once, there’s little disagreement among the health sector’s diverse interest groups. The APMA isn’t keen (but would like greater opportunity for “highlighting disease states” to the public), and nor are consumers or medical groups.

Peter Mansfield, of the Medical Lobby for Appropriate Marketing, says DTC has backfired against industry overseas. “A lot of doctors in New Zealand and the US are very annoyed with direct-to-consumer advertising because it means they’re having to spend a lot of time dealing with people who decided for themselves what’s best for them without understanding the adverse effects that are not mentioned in the advertisement and not knowing about the cheaper alternatives which are not promoted”.

How would consumers manage their way around competing drug company claims when doctors find it difficult enough to do so?

Professor David Henry, professor of pharmacology at the University of Newcastle, cites a recent ad which he says uses complicated statistical gymnastics to turn an 8.7% reduction in the relative risk of vascular ishaemic events compared with aspirin into a 26% difference.

He says it took a PhD biostatistican to work out how the statistics had been arrived at. The manufacturer, Bristol Myers Squibb, says the results have been phrased appropriately in the overall context of the advertisement.

Of course, medicines are already being widely promoted on the Web.
Perhaps the real issue is how we can all become better equipped to evaluate health information. Professor Henry speaks of the need for “immunisation” against advertising claims through “learned scepticism”. Probably a more realistic option than an injection of transparency into advertising.


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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