Healthy Skepticism Library item: 1683

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

Johnson E.
Direct-to-consumer advertising
2002 Feb 27

Full text:

You might have seen the advertisement and wondered what it’s for: A man comes dancing out of his house, sashays down the street, leaps over the newspaper box. Then you see the word: Viagra.

The ad is deliberately vague because that’s the regulation in Canada. The drug companies want to change those regulations, but a new study suggests our healthcare system could pay the price.

In Canada, there’s a limit to what drug ads can say: they can advertise the name of a product or say what it treats. But they cannot do both at the same time. Like the Viagra ad, you only see ads that give the name of the drug and only hint at what it’s for.

“If we’ve been asking people to take charge of their own health decisions, how can you tell them to take charge of their lives but then say ‘Don’t read this,’ ‘Don’t watch that, and ‘by the way, believe me’ as opposed to making any sort of choices yourself,” Murray Elston said. He speaks for Canada’s brand-name pharmaceutical companies.

Health Canada is under pressure from drug companies, advertising agencies and broadcasters to loose the rules. The agency is set to release proposed changes to the current rules, but critics are worried that looser laws will drive up drug sales and put our healthcare system under even greater strain.

Health researcher Barbara Mintzes is alarmed by the increasing number of drug ads we see every day.

“The ads look like any other ad for a car, for a cosmetic. And it makes it look like taking a prescription drug is just the same as going out and buying a candy bar. It really trivializes the medical treatment.”

Mintzes is part of a research team at the University of British Columbia. It recently published the first study of its kind, looking at how drug advertising affects what patients ask for in the doctor’s office.

Drug ads sell

The study found that Americans in Sacremento were twice as likely as people in Vancouver to ask for new and often costly brand name drugs.

“Newer does not equal better. Many of the drugs released on the market are what are called ‘me too’ drugs. They’re very similar to what already exists,” Mintzes said.

“They feel hard done by if you say the really tough word: No”
Vancouver family physician, Dr. John Mail
The study also found that those who asked for a specific drug they’d seen advertised got it almost 75 per cent of the time.

Vancouver family physician Dr. John Mail says some of his patients come in quoting television commercials and demanding the newest product.

“Some people are very insistent on it, because they’ve heard about it through an ad, or seen it in a magazine. And they feel hard done by if you say the really tough word: No,” Mail said.

One disturbing finding of Mintzes’ study was then when patients asked doctors for advertised drugs, they got them, even though half the time their doctors had mixed feelings about prescribing the products.

“I suppose it’s okay to dispense something that doesn’t cause any major harm, as long as people are fully informed of the benefits – or lack thereof,” Dr. Mail said.

As any Canadian who watches American television knows, drug advertising in the U.S. has exploded. Laws were loosened there five years ago. Last year, pharmaceutical companies spent $2.5 billion on advertising – and drug sales are soaring.

“I think consumers have a right to know and a need to know that, if they have a particular health disorder, that there is a treatment available and that they can ask for that treatment,” says health activist Durhane Wong-Reiger. She heads a coalition of patient groups called Advocare. The group has been lobbying Health Canada to allow more drug advertising.

“There are lots of new treatments, and it’s really difficult for the general practitioner to keep on top of all the kinds of possible treatments that there are. And many times it’s the patient that will know best,” Wong-Reiger adds.

Researcher Barbara Mintzes worries that sometimes too little is known about new drugs.

“Increased drug advertising will lead to increased prescribing and increased costs to the healthcare system,” says researcher Barbara Mintzes
“One of the big concerns with new drugs is we know very little about their longer term risks, or less common risks, when a drug is first brought to market. [The drugs] just haven’t been tested on enough people yet.”

Time may be right for more drug ads: Health Canada

Health Canada’s Ross Duncan says it may be time to allow more drug advertising: “Some people believe that if regulated effectively, advertising can be a good means of conveying high-quality information to consumers.”

Duncan says ads for new drugs would be closely monitored. Critics argue Health Canada’s track record speaks for itself.

Two years ago, the makers of Zyban – a drug used to help people quit smoking – ran an ad that named the product and said what it’s for. That’s against the rules.

The ad ran for four months. Health Canada sent the manufacturer two warnings letters, but never prosecuted the company.

After the Zyban controversy, Ray Chepsiuk of Pharmaceutical Advertising Advisory Board received a lot of calls from advertising agencies. He’s paid by the drug companies to keep their marketing within the rules.

“They were wondering ‘What can we do for our clients?’” says Chepsiuk. “They were saying ‘Can we do that?’ ‘Is that okay?’”

Barbara Mintzes wonders why there’s talk of deregulating drug advertising if there’s a problem enforcing the current rules.

Pressure for more ads on two fronts

Health Canada is coming under mounting pressure not only from drug companies, but also patient advocacy groups – some of which, like Advocare, receive part of their funding from drug companies.

“My point of view is not affected by the drug companies,” says Advocare’s Durhane Wong-Reiger. “I personally have a very strong commitment for patients and their need to know. I think that’s the bottom line for me.”

Barbara Mintzes’ research has just been published in the British Medical Journal. Part of her study found that even though drug advertising drove up drug sales in the United States, there’s no evidence to show it has improved peoples’ health.

The study does make one thing clear: Increased drug advertising will lead to increased prescribing and increased costs to the healthcare system.

“The biggest increase in healthcare costs has been drugs. I think that consumer-driven demand for it will make that figure much bigger,” says Vancouver doctor John Mail.

That has the Canadian Medical Association, the Consumers’ Association of Canada and provincial health ministers across the country, concerned there will be an onslaught on drug ads in the near future.