Healthy Skepticism Library item: 13092

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

Goar C.
Say no to drug ads, doctor warns
The Toronto Star 2008 Mar 7
http://www.thestar.com/comment/article/310212

Full text:

Dr. John Abramson came to Toronto this week with a cautionary tale. The
Harvard medical professor was in town to tell Canadians and their courts
what happens when a country opens its airwaves, newspapers and magazines to
pharmaceutical advertising.

The United States did it, to his everlasting regret.

Abramson was a family doctor practising in a bedroom community north of
Boston when Washington relaxed its advertising rules. He watched his
patients turn into supplicants for heavily marketed drugs. “They kept coming
in, asking for – and often demanding – expensive drugs they didn’t need. I
couldn’t talk them out of it.”

He was a medical researcher when Vioxx, a new arthritis drug, was being
tested for widespread use. He watched America’s leading medical journals
publish incomplete and misleading data about its risks. He watched the media
spread this information uncritically and the manufacturer launch a massive
advertising campaign. “What’s printed in these journals is accepted as
truth.”

He was an instructor of primary care at Harvard when he started speaking
out. He watched his colleagues distance themselves, discounting his findings
and shrugging off his evidence. “There’s tremendous pressure to conform.”

Canada still has a chance to avoid this scenario, Abramson says.

“My recommendation would be to have no direct consumer advertising in any
way, shape or form.”

The Ontario Superior Court of Justice will decide this summer whether to
lift Canada’s long-standing ban on such advertising. The case is scheduled
for June 16.

This is the final phase of a legal battle that began in 2005, when CanWest,
the country’s largest media company, challenged Ottawa’s right to prohibit
drug companies from advertising directly to consumers. The Winnipeg-based
communications conglomerate, which owns 65 broadcast, print and online
outlets, said the ban violated its constitutional guarantee of freedom of
expression.

Both sides have now submitted their affidavits. Expert witnesses are
undergoing cross-examination. Abramson testified Tuesday.

He represents a coalition of unions, medicare advocates, women’s groups and
academics who want the current law left in place. They are backing the
Crown.

CanWest’s supporters include the brand-name drug makers, several major
advertising agencies and the Canadian Newspaper Association (of which the
Star is a member).

The stakes are high. Americans spend $356 more per capita on prescription
drugs than Canadians do. The pharmaceutical industry in the U.S. spends $4.8
billion a year on direct-to-consumer advertising.

To Abramson, it comes down to a choice between corporate free speech and
public health. “The core issue is the commercialization of medical
knowledge.”

He cites three principal reasons to avoid the path taken by his country:

The first is patient safety. Information disseminated by the drug companies
is designed to increase corporate profits, not to give consumers the facts
they need to choose the best treatment option. A succession of heavily
promoted drugs – painkillers, anti-psychotics, hormone replacement
medications – has been pulled off the U.S. market because of inadequate
testing or undisclosed risks.

The second is cost. Pharmaceutical spending in America has ballooned since
Washington opened the floodgates to consumer advertising. It’s partly
because doctors are prescribing more drugs and partly because patients are
insisting on expensive brand-name medications they’ve seen on TV.

The third is the distortion of the doctor-patient relationship. People come
into their physician’s office with a pre-set idea of the drug they want.
They aren’t ready to discuss lifestyle changes. They aren’t willing to
entertain the possibility that they don’t need a pill for restless leg
syndrome, social anxiety disorder, menopause, baldness or loss of libido.

The best hope for his country, Abramson says, lies in better patient
education and a new federal agency empowered to certify that drug research
is properly conducted before the results are published.

Canada doesn’t need such correctives – yet.

“Your health-care system is working very well at 55 per cent of the cost of
ours,” he says. “You can still protect it by not opening the floodgates to
free enterprise.”