Healthy Skepticism Library item: 20487

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

Swan N
Drug sales talk could be misleading, experts say
The Sydney Morning Herald 1988 May 46

Full text:

Doctors, when asked about freebies from drug companies, usually express confidence that they can accept the trip, lunch or dinner without changing their prescribing habits.

But the fact that firms continue to spend a fortune of handouts rather than investing in Australian medical research suggests that there is a financial benefit from cultivating doctors.
It has been shown in several countries that a worrying proportion of doctors rely on drug sales for their continuing education.
The question, then, apart from the ethics of the situation, is whether the marketing information from the pharmaceutical companies is reliable. And it may be that at least one-third is not.

Take Lomotil for example. The manufacturer, G. D. Searle, is accustomed to controversy over this
medication. In adults, Lomotil is only of use in a narrow set of circumstances and in Australia must not be used in children under 12. The risk of side effects in children is greater than
adults and there is no evidence that children are helped by any antidiarrhoeal agent. The problem is that preparations like Lomotil constipate the patient, who retains the germs that would otherwise have been expelled.

Despite this, for a long time, Searle’s subsidiaries in some developing countries put out recommended doses for children and even babies.

Diarrhoea kills millions of infants every year in impoverished nations.
These children don’t need an unproven drug; they must have fluids
to prevent dehydration. Searle amended its literature on Lomotil’s use in children after lobbying by Social Audit, a British consumers group.
The Medical Lobby for Appropriate Marketing (MaLAM) is an international organisation run from Adelaide with an impressive membership of experts on prescription drugs.

MaLAM wrote to Searle asking why it still sold Lomotil at all in developing countries where the
infecting organisms have a much more pernicious effect on individuals
than in the West. MaLAM also requested scientific evidence or Lomotil’s effectiveness in this situation.

But in reply, Searle offered the fact that the US Food and Drug Administration has approved Lomotil’s use in diarrhoea.

Of course Lomotil is not alone in the issue of selling drugs to the
developing world. Bayer sold a tonic in Pakistan which contained strychnine and arsenic until MaLAM wrote to them about it. Bayer’s tonic had recommended doses for children too.

We imagine that misleading advertising is only a feature of the Third World, but in fact it is quite common in Australia. A group from the Australian Society of Clinical and Experimental Pharmacologists studied drug advertisements over two years and found that a third were unacceptable.

At the moment there is a gathering cloud over the keenly contested market for anti-arthritis drugs called Non Steroidal Anti inflammatory Agents (NSAIDS). It is possible that one in five Australians over 60 are taking these drugs, which have side effects like stomach bleeding and kidney damage. The battle for the is over which company has the safest NSAID.
According to Dr Peter Mansfield of MaLAM, there has been no well-conducted study comparing the
side effects of the various NSAIDS.

Therefore, he asks, how can manufacturers make the claims they do?