Direct to Consumer Prescription Drug Advertising

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http://www.web.ca/~desact/anglais/public/dconsumer.htm

 

 

Direct to Consumer Prescription Drug Advertising: When preventing harm is no

longer a priority

 

 

 

" Since autumn 1999, a number of prescription drugs have been advertised directly

to consumers in major Canadian cities. Two examples are Diane-35, a hormonal

product approved in Canada for the treatment of severe acne, and the oral

contraceptive Alesse. "

 

 

 

 

 

" True or False: Canadian law prohibits advertising of prescription drugs

directly to consumers. " The correct answer is " True " but Health Canada is not

enforcing the law.

 

This and other test questions are included in a new brochure prepared by DES

Action Canada and the Working Group on Women and Health Protection. The purpose

of the brochure is to alert Canadians about the serious impacts of

direct-to-consumer advertising (DTCA) of prescription drugs. The impacts are

clearly visible in the USA since the relaxation of its laws regarding DTCA in

1997. And the relaxation in US legislation is already slipping through Canada's

back door via cable TV advertising. Also, in several major Canadian cities,

advertisements on billboards and bus shelters direct people to 1-800 numbers for

information on prescription drugs. These ads are in violation of Canada's Food

and Drugs Act.

 

DTCA ban

Direct-to-consumer advertising for prescription drugs is banned in most

industrialised countries in the name of health protection and medical ethics. It

is legal only in the USA and New Zealand. As a result of the increase in

prescription drug advertising in the USA, there has been a dramatic increase in

the sales of prescription drugs, especially those that are heavily advertised

such as antidepressants, oral antihistamines, and ulcer treatments. This may

potentially lead to increased health risks from adverse effects or from the

risks associated with drug interactions.

 

Advertising prescription drugs is not the same as advertising a new consumer

product. Prescription drugs are associated with serious harmful effects and must

be subject to strict regulation. People who are ill and in need of medication

are vulnerable consumers and need access to objective and comprehensive

information about treatments to be able to make informed healthcare choices.

Despite the assertion by drug companies that consumers have a right to the

information provided by advertising, it isn't possible to obtain objective

medical information from drug advertisements. Manufacturers pay for advertising

space only to promote the product they are selling. For example, an

advertisement suggests that you " ask your doctor about weight loss options that

are available now. " A drug company will not suggest that you " ask your local

community centre about a membership that is available now " although the evidence

in favour of exercise vastly overshadows the questionable benefits of diet

drugs.

 

The main objective of advertising prescription drugs is not to provide

information but to increase sales for pharmaceutical companies. To achieve this,

advertising is often misleading, downplaying the risks associated with drugs,

exaggerating benefits and implying that drugs may be used to treat a wider range

of conditions than they are approved to treat. Also, prescription drug

advertising strongly promotes the newest drugs available - drugs that are

usually more expensive and not necessarily more effective or safer than those

that have been on the market longer.

 

 

" The massive growth in spending on direct-to-consumer advertising in the US from

$55 million (US dollars) in 1991 to $1.8 billion in 1999…in the US, prescription

drug spending increased from $50.6 billion in 1993 to $93.4 billion in 1998,

indicating that this form of advertising is likely to be paying off. "

 

 

 

Direct-to-doctor ads

Pharmaceutical companies have also been aggressively targeting physicians with

direct-to-doctor advertising of prescription drugs. Unlike DTCA, it is legal to

advertise directly to doctors. However, as with DTCA, the advertisements often

minimise drug risks and misleadingly represent the benefits. Studies have shown

that physicians who rely heavily on drug promotions for information are less

likely to prescribe " appropriately, " i.e. less likely to prescribe a drug for

the condition it is indicated to treat, less likely to prescribe the right dose,

and less likely to avoid prescribing unnecessarily harmful drugs. These

physicians are also less likely to prescribe the least expensive available drug.

 

Drug promotion to physicians in Canada is mainly regulated by the pharmaceutical

industry itself. If a company's advertising is found in violation with Canada's

Food and Drugs Act, the offending advertisement may be pulled without any

subsequent correction and the company may be fined from $1000 to $20,000 - a

figure which many multinational pharmaceutical companies could easily consider

" part of the cost of doing business. "

 

Raising public awareness

DES Action Canada and the Working Group on Women and Health Protection feel

strongly that public awareness about DTCA of prescription drugs is especially

important at this time due to the proposed changes to our national health

protection legislation currently under review by Health Canada. One of the

proposals is to replace the Food and Drugs Act with a new federal Health

Protection Act and, with it, to introduce direct-to-consumer advertising for

prescription drugs. In other countries, public awareness and consumer complaints

about DTCA for prescription drugs have been effective in influencing governments

to enforce the prohibition of DTCA. Unfortunately, despite official complaints

and the efforts of over 20 consumer groups across the country, this is not yet

the case in Canada.

 

In the new brochure, DES Action Canada and the Working Group on Women and Health

Protection recommend that: DTCA for prescription drugs should be prohibited by

law in Canada given the lack of evidence of health benefits and the serious

potential for harm; the public must have access to comprehensive and objective

information on prescription drugs; regulation of drug promotion to doctors must

be done by Health Canada or an independent body at arm's length from the

pharmaceutical companies and from the advertising industry; and, the principles

of the Food and Drugs Act must be enforced. The final recommendation addresses

the excessive medicalisation faced by women and states that: regulation of drug

promotion should include representation by women's organisations and explicit

attention to gender equity.

 

The DTCA booklet, researched and written by Barbara Mintzes and Rosanna Baraldi,

is available from DES Action Canada office.

 

 

 

For DES exposed daughters, sons and mothers, the DTCA issue is a sensitive one.

Remember: in the fifties, DES was advertised to doctors with the slogan : " For

routine prophylaxis in ALL pregnancies - bigger and stronger babies, too. "