Healthy Skepticism Library item: 20110

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

Landon L
Pushing drugs
The Ottawa Citizen 2001 Jun 56

Abstract:

A spate of advertising for prescription drugs, some with potentially dangerous side-effects, worries health advocates, but the law is somewhat unclear, as Laura Landon reports.

Full text:

Diane was in a public bathroom singing about her freshly killed pimples the first time Sharon Batt saw her.

Underneath a picture of the jubilant, clear-skinned Diane was a subtle message implying that she was homely and glum before discovering “the acne solution for women only”.

“I was shocked. This was right in the washroom in the student union building” said Ms Batt, a professor of women’s health at Mount Saint Vincent University in Halifax. “Because I work with university women, it really shocked me to see this ad and that they would see this ad. And there’s no way they could know the story”.

The story, she says, goes like this: Diane is the fictional poster-girl for “Diane-35” – a controversial oral contraceptive being sold as an acne treatment. And although prescription drugs are illegal in Canada, posters trumpeting drugs with potentially dangerous side-effects, such as Diane-35, are popping up on billboards, bathroom stalls and bus shelters across the country, while Health Canada does little to stop them.

The pharmaceutical companies that sponsor the ads say they inform the public about new drugs.

But those against the ads – including the Canadian Medical Association – say prescription medicines are too serious to be marketed like any other consumer product.

“We knew the drug companies were pushing to be able to advertise in Canada, and we were just waiting for them to start bringing the ads out”, says Ms Batt, a member of the Working Group on Women and Health Protection, which includes the Consumers Association of Canada and the Canadian Health Coalition.

The group has been on a cross-Canada tour to tell people about prescription drug ads; it will bring its research and warnings to Ottawa on Thursday, when it will hold a panel discussion on Parliament Hill and meet with representatives from Health Canada.

While the United States loosened regulations on prescription drug ads in 1997, Canada’s Food and Drugs Act has forbidden them since 1953.

But a 1978 amendment is being re-interpreted as a loophole for advertisers, said Barbara Mintzes, a University of British Columbia, a University of British Columbia epidemiology student finishing her PhD thesis on direct-to-consumer advertising.

The amendment was meant to allow price comparisons for shoppers in drug stores, and restricts drug advertising to postings of price and quantity along with names of drugs.

“It’s very specific”, says Ms Mintzes, who also co-ordinates a study funded by Health Canada into the effects of drug ads, the results of which should be released in September. “But what I’m increasingly seeing are more ads.

“The first one I saw was in December 1999, right before the New Year, and I couldn’t believe it.

“It said ‘Zyban – ask your doctor”, she said, referring to the anti-depressant being sold as an aid to stop smoking.

The purple billboards are subtle: One ad shows a middle-aged couple in bed, smiling in a presumably post-coital manner. Another shows a china coffee cup and plate. The billboards make no explicit mention of Zyban as a smoking cure, but leave the connection between sex or coffee – and their oft-attendant cigarettes – up to the imagination of the viewer.

After seeing her first Zyban ad, Ms Mintzes wrote to Health Canada.

A spate of other drug ads inspired more complaints from Ms Mintzes and her colleagues.

Health Minister Allan Rock’s reply to their letters surprised them. He said the ads are not necessarily illegal if they avoid explicitly linking the name of a drug with the condition it treats.

Both Ms Mintzes and Ms Batt argue the minister is incorrect, since nothing in the Food and Drugs Act permits such ads.

Ross Duncan, a Health Canada official reviewing drug ad legislation, said the act prohibits direct-to-consumer advertising, but certain allowances have evolved out of the 1978 amendment.

Prescription drug ads are illegal in all industrialized countries except New Zealand and the United States.

All-out legalization in Canada is one option, Health Canada’s Ross Duncan said, but so is further restricting ads.

“In the meantime, it’s status quo”, he said. “There’s no change in policy”.

But pharmaceutical companies aren’t so sure. “What are the latest regulatory changes? How far can you go?” asks a flier from a pharmaceutical industry conference held in Toronto in mid-May.

“In Canada it has always been a very grey zone of what’s allowed, and what you can come out with on the street and in the journals and directly to the public”, said Dr Francis Charette, a vice-president at Berlex Canada Inc., which makes Diane-35.

The Berlex “Diane” ads wouldn’t even be legal in the United States, said Ms Mintzes, since side-effects have to be listed on ads that name a drug and its purpose.

“Actually, it might be sort of a corny answer, but the name of the drug is Diane-35; it’s not Diane”, Dr Charette said in defence of the ad. “It may be pushing it a bit”.

Similarly, Wyeth-Ayerst Canada, which has a series of ads for Alesse, a birth control pill, employs clever plays on words and shows a bubble-pill pack without ever explicitly stating what the drug is for.

Last year, Health Canada concluded that Wyeth-Ayerst went too far with a series of television ads and sent the company a warning letter six months after the ads began airing on Much-Music.

“There’s no power that allows Health Canada to remove advertising from the air”, Mr Duncan said. Instead, the government told Wyeth-Ayerst to consider Health Canada regulations before airing future ads.

“The material in those ads currently is compliant”, Mr Duncan said. He added that Health Canada is now investigating certain Zyban ads.

Meantime, it’s left to the public to complain to Health Canada as the ads appear.

When University of Ottawa graduate Jessica Carfagnini saw ads for Diane-35 on her campus earlier this year, she was angry.

“The impression given off is that if you have a couple of pimples, you should rush off to your doctor for this pill”, said Ms Caragnini, who works at the campus Public Interest Research Group. “There was no mention of hormones or side effects”.

Everybody thinks they’re not affected by advertising, or are clever enough to see past the spin, Ms Carfagnini said. But if ads aren’t effective, why are pharmaceutical companies spending millions of dollars on them?