Healthy Skepticism Library item: 1656
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
Fraser M.
Drugs, ads and the 'direct' debate: Broadcasters want ability to peddle brand name drugs
Financial Post 2002 Jan 21
Full text:
Viagra may be more than a medicated quick fix for erectile dysfunction syndrome.
In Canada, the wonder drug could also provide a potent lift to the flaccid advertising market that has softened the usually robust revenue performance of major media companies.
That’s what the Canadian Association of Broadcasters is hoping. CAB has been lobbying Ottawa to deregulate a long-standing ban on commercial advertising for prescription drugs.
CAB’s bottom-line interest in direct-to-consumer, or DTC, drug advertising is roughly quantifiable. If Ottawa lifted its ban, an estimated $400-million in advertising revenue would flow to Canadian media companies — about 60% to broadcasters, and the remainder to magazines, newspapers and other media.
CAB also argues DTC drug advertising is good public policy. Canadian consumers, if better informed about available medications, would take a more proactive approach to treatment. Canadians, in any event, already watch U.S. drug commercials directly on U.S. TV channels. Thus Canadians have de facto access to drug advertising — often, ironically, for drugs that have not been approved by Canadian bureaucrats.
The cross-border influence goes further. Canada’s regulation-sanctioned specialty TV channel, Discovery Health, is a partnership between Toronto-based Alliance Atlantis Communications Inc. and U.S.-based Discovery Networks. This would appear to make both commercial and biological sense, as the ailments that afflict the human body are — so far as I know — identical in both the United States and Canada. Still, while the U.S. health channel can broadcast drug advertising, its Canadian counterpart cannot.
The DTC advertising debate provides a textbook example of how U.S. policies seep into Canada, via media osmosis, and impose their tenets normatively. But since Canada has distinct institutional agendas, the graft is resisted here like a rejected organ transplant.
DTC drug advertising was once controversial in the United States. Powerful U.S. lobbies — health providers, insurers, doctors and pharmacists — marshalled familiar arguments warning about increased usage of prescription drugs and spiralling costs due to pharmaceutical advertising.
In 1985, the U.S. Food and Drug Administration allowed drug makers to buy television ads to promote new remedies for diseases — but without naming any specific drug. This is where Canada is today: Viagra is the drug that dare not speak its name.
In 1997, the FDA opted for deregulation. Drug companies henceforth could advertise a specific brand of prescription drug and name the particular condition it treats. The FDA nonetheless made a sop to two powerful lobbies: U.S. pharmaceutical advertisers must state where consumers can obtain further information — and, moreover, must identity doctors and pharmacists as primary sources.
FDA deregulation immediately became a boondoggle for U.S. media companies. While in the early 1990s pharmaceutical giants spent roughly US$55-million a year on media advertising, spending shot up to nearly US$2-billion in 1999. Today, estimates put the figure at nearly US$3-billion.
The U.S. medical profession still argues that DTC advertising fails to inform consumers of the “risks and costs” of specific drugs. The medical lobby also claims DTC advertising promotes high-cost, branded drugs while neglecting lower-cost generic drugs and other treatment alternatives.
Yet the medical profession has long resisted disseminating information about drug treatment, mainly because its corporatist interests are strengthened by broad consumer ignorance. Like all monopolists, doctors and pharmacists have jealously guarded their gatekeeper power over knowledge about prescription drugs.
Drugmakers actually spend more on “advertising” their brands vis-Ã -vis physicians — either through free samples or doctor “detailing.” This practice sometimes includes educating physicians with such inducements as first-class, all-expenses-paid trips, professional “conferences” in such exotic places as Hawaii during bitter January cold.
In 1999, U.S. pharmaceutical companies spent US$1.8-billion on media advertising, US$7.2-billion on free samples to physicians, and US$3.6-billion on detailing.
In Canada, CAB’s calls for DTC deregulation have largely fallen on deaf ears. No wonder: The ban is imposed by Health Canada, a ministry where medical lobbies enjoy “insider” status and so have more clout than Canadian broadcasters.
Redoubling its efforts, CAB has joined with newspaper and magazine lobbies to form an ad hoc group with a high-minded name: the Alliance for Access to Medical Information. Its slogan is a cautious made-in-Canada solution that would ensure, among other things, that drug ads are “pre-screened” and self-regulated.
Politicians usually like to curry favour with broadcasters and newspapers owners, who can influence elections. But DTC drug advertising has another powerful adversary — provincial governments. The provinces dispense health care in Canada. And they fear DTC drug advertising will lead to increased health costs downloaded on to their treasuries.
They may be right, in the short term. But the provinces should consider this: Consumers, by taking a proactive approach to their health, will take prescription drugs today to avoid future ailments that would be even more costly to taxpayers later.
True, some “blockbuster” drugs advertised in the media treat vanity ailments such as impotence, baldness and acne. But many top-selling DTC-advertised drugs are prescription medication in such categories as anti-obesity, smoking cessation, anti-cholesterol, anti-Alzheimer’s and diabetes.
Harmonizing Canada’s drug advertising rules with U.S. policy makes sense. But never underestimate the rigidity of bureaucracy and the influence of health lobbies who will fight it.
mwfraser@rogers.com
