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Healthy Skepticism Library item: 20170

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

McLean DL
Debate: drug advertising: Yes
Australian Doctor 1999 Oct 8


Direct-to-consumer advertising of prescription medicines would be an excellent way of meeting the public’s growing need for medical information.

David L McLean is the managing director of healthcare advertising agency Sudler & Hennessay, a leading global healthcare advertising and communications agency operating in Australia from Sydney and Melbourne.

Full text:

Advertising across mass consumer media to patients about diseases, treatments and health issues is an increasing world trend.

Direct-to-consumer advertising – or, as we at Sudler & Hennessey prefer to call it, direct-to-patient advertising – is a powerful communications methodology that can benefit patients, doctors, pharmacists and the health of the nation.

Such a powerful claim may raise eyebrows, but let me prove my point.

Unbranded (ie, no product mentioned or identified) advertising about a disease state directs patients to their doctor for communication, diagnosis and, if warranted, treatment.

Such patient advocacy or disease awareness makes the public more aware of health issues, encourages informed dialogue with healthcare practitioners, demystifies taboo areas and empowers patients.

In the US and a few other countries, advertising of branded prescription (S4) medicines to the public is allowed (and, in the US, if a claim is made then prescribing information is included in the advertising).

I don’t advocate such advertising in Australia at present. Having patients arriving at their GP requesting specific brands arguably impinges upon the doctor’s therapeutic freedom.

So I propose that unbranded, disease-specific advertising benefits the community. Who could argue that encouraging patients to quit smoking is not in the public interest?

When nicotine patches were first launched, some pharmaceutical companies ran advertising campaigns ran advertising campaigns urging patients to see their doctors if they wanted to quit.

The ads never mentioned specific treatments, so the GP had the option of counselling, hypnotherapy, gum patches, or whatever. The doctor’s authority over the treatment protocol was not compromised.

This coincided with federal and state campaigns with the same objectives and tens of thousands of smokers were motivated to see their doctor.

There are many diseases that still require more widespread diagnosis, for example, diabetes. Wouldn’t it be in the national interest if public advertising motivated many of the 350,000-plus Australians with undiagnosed type 2 diabetes to receive earlier diagnosis and treatment? The long-term outcomes are self-evident.

There are more “hidden” disorders where patients can be helped to discuss issues freely with their doctor, erectile dysfunction being one. Advertising can give the sufferer and his partner the confidence they need to discuss this widespread and under-treated syndrome. And the doctor might uncover some concomitant condition in some patients at the same time,

What about depression and psychiatric illness? How many undiagnosed/untreated people are suffering unnecessarily – and affecting the lives of others – when early treatment might help them to remain productive members of the community, living normal, happy lives?

The ultimate tragedy of untreated depression – suicide – is in the news on a daily basis. Consider the lives that could be saved; consider the savings to the community generated by the modern psycho-pharmaceuticals.

Critics of disease-specific advertising claim it increases the cost of the healthcare system, benefits drug companies, and encourages patients to make unnecessary doctor visits. Some of the criticisms may be partly true – on the surface. But let’s go deeper.

*The earlier the intervention, often the better the disease outcome (irrespective of drug treatment).

*Many diseases remain under-diagnosed and can be silent killers (look how successful public education about blood pressure checks has been in reducing CV mortality).

*Medicines save lives and offer patients healthier lifestyles. The proper use of medication can reduce the nation’s health costs. Compare early treatment of hypertension and/or hypercholesterolaemia with the costs of stroke to the community.

*Critics display an ignorance of the sensitivity, expertise and finesse that go into the creation of these public awareness campaigns. They also fail to appreciate the responsible and ethical manner in which the pharmaceutical industry regulates itself.

Today, patients are consumer who rightfully demand knowledge and information. Healthcare is at the top of consumers’ interests. Informed patients are far more likely than uninformed patients to take more responsibility for their health, to comply with treatment, to communicate more openly with their doctor and pharmacist.

So let’s not knock drug companies for sponsoring advertising that helps consumers seek healthier lives. The GP is the first port of call when someone is stimulated by advertising to seek help, and that doctor’s professional capability to diagnose, to treat or not to treat, is only enhanced by direct-to-patient advertising.

Doctors should have no misgivings that pharmaceutical manufacturers recognise absolutely that it is the doctor who is the final arbiter of what is prescribed or recommended.


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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909