reduces heart attacks and stoke rates

 is superior in anyway over interventions other than its components alone.

[more about the evidence]

Is the message you get from the advertisement justified?

The message I get from the advertisement is:
  . justified. mostly justified. mostly not justified. not justified. unsure. no opinion.

What messages would you like to send?

Comments addressed to Boehringer Ingelheim:
 

Comments addressed to AdWatch:
 

AdWatch's current recommendation for Australia

Therapy for uncomplicated hypertension. 

First line: Lifestyle changes (including better diet[5] and physical activity) have benefits beyond reducing hypertension.

Second line:  chlorthalidone 25mg ½ daily.[6]  [our reasons]

Diabetics may benefit from additional therapy.  It not clear if any other group gains total mortality and/or quality of life benefits from additional drugs.  For the following drug classes we do not know which drug is the best in it’s class.

Third line:  Beta-blocker

Fourth line:  ACE inhibitor

Fifth line:  Long acting Calcium Channel blocker

Sixth line: A2 blocker.  A2 blockers are rarely useful except when an ACE inhibitor would be appropriate but is not tolerated because of the ACE cough.[7] 

Comments about AdWatch's current recommendation for Australia:
 

Before reading this AdWatch issue
I . prescribed took recomended Micardis Plus . never rarely sometimes often  

I now plan to . prescribe take recomend Micardis Plus . less often as often more often .

I am a . doctor (not a general practitioner) general practitioner journalist medical student member of the public other health professional pharmaceutical industry employee pharmacist pharmacy student other

I live in . Australia Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d'Ivoire Croatia (Hrvatska) Cuba Cyprus Czech Republic Congo (DRC) Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Islas Malvinas) Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern and Antarctic Lands Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Samoa San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam Virgin Islands (British) Virgin Islands Wallis and Futuna Yemen Zambia Zimbabwe

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Appendix: Response from Boehringer Ingelheim

25 May 2004

Dear Dr Mansfield,

MicardisPlus® Advertisement

Thank you for your recent e-mail regarding the advertisement in 2003 for
MicardisPlus.

Boehringer Ingelheim believes that the MicardisPlus advertisement cited
conveys, in an arresting and interesting manner the importance of good 24
hour BP control for hypertensive patients, and the principle aim of the
message is to reinforce that MicardisPlus offers this.

Imagery such as the ‘the man in bed on the rail tracks’ conveys the notion of
sometime in the early morning, which is at the end of the 24 hour dosing
period for most people and when some once daily BP medication may no
longer be providing as effective control. This was demonstrated in the
clinical trial referenced when looking specifically at the last hours of the
dosing period.

During the morning period an increased incidence of cardiovascular
morbidity and mortality is now well recognised from the literature as you
point out.

The antihypertensive effect of MicardisPlus is greater than that of the
individual components, Micardis or hydrochlorthiazide. This additional
antihypertensive effect may be needed for patients uncontrolled on either of
the individual components.

MicardisPlus was newly introduced into the Australian market in 2003 and
the reader is alerted to this. The use of the word ‘new’ during the first year
of marketing is compliant with the Medicines Australia Code of Conduct of
the use of this word in advertising. The word ‘new’ is no longer being used
in the 2004 advertising for MicardisPlus.

At Boehringer Ingelheim we take great care in the formulation of our
advertising for all of our products, including MicardisPlus, and this
advertising campaign is in accordance with a global corporate program. All
our promotional activity is reviewed very carefully for accuracy and for
compliance with the Medicines Australia Code of Conduct. As such we are
satisfied with the MicardisPlus advertisement and believe your criticism is
unwarranted.

Yours sincerely,
Boehringer Ingelheim Pty Ltd

Dr Rob Creek
Medical Director