Healthy Skepticism Library item: 2205

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

Cassels A.
The new drug pushers
Montreal Gazette 2001 Nov 9

Abstract:

Hawking drugs directly to the consumer is new advertising trend

Full text:

I bet I’m not the only one these days noticing more and more stories in magazines trying to get me to see my doctor about a treatment for “social anxiety disorder” (SAD). The symptoms sound pretty familiar – sweaty palms, nervousness in a crowd, and so on. Who knows, given the right encouragement, I guess I could be convinced I am sick.
Or how about those ads steering us to think we might have “generalized anxiety disorder” (GAD), or “post-traumatic stress disorder” (PTSD) to suit our anxious, post-Sept. 11 times?

What is going on here? Are we really more anxious or is this just crass commercialism tapping into anxiety and trauma to hard-sell us pharmaceutical treatments?

Well, it’s actually both. Even before Sept. 11, the anxiety meter was already tilting into the red zone, if you take anti-depressant drug sales as any measure. According to IMS Health, a company that tracks pharmaceutical trends, sales of anti-depressants experienced 18 per cent growth in 2000 – totaling $13.4 billion per year.

As for the crass commercialism side, a lot of the stories around any “new” medical condition are often part of the marketing effort of companies making the drugs to treat those conditions. The buzz around drugs for SAD (what we used to call shyness), for example, can be traced to the handy scribes at a New York public-relations agency, Cohn Wolfe, which was hired to prime the media for Paxil, the first FDA-approved drug for SAD. They did a good job, too – sales of Paxil have blossomed considerably.

It’s like the marketing for the drug did not respond to, but created, the epidemic of social anxiety out there.

Such disease creation is a hot topic lately in Europe, where a shift in European Union legislation will allow pharmaceutical companies to mount disease-awareness campaigns to European consumers.

These aren’t allowed in Canada, if they are tied to specific drugs, but with Europe going this way, some see this as the first step in making full-blown Direct-to-Consumer Advertising of prescription drugs a global phenomenon. Only two countries in the world haven’t banned DTCA – the U.S. and New Zealand – so European and Canadian consumer groups are horrified at the prospect of relaxing the rules that would allow more American-style drug advertising.

Barbara Mintzes, a University of British Columbia-based expert in consumer drug advertising is troubled by the direction Europe is going. “I’ve seen how damaging this kind of disease mongering and drug marketing is in New Zealand and the monstrous waste of money on expensive new drugs it incurs.”

Since 1997, when drug advertising legislation was relaxed in the U.S., DTCA has grown to a $2.5-billion-a-year industry. All this hawking of prescription drugs directly to consumers is causing havoc in public-health systems, especially in terms of rising drug budgets. There are currently more than 50 bills working their way through U.S. state legislatures to try to provide some damage control.

All that marketing of drugs really does make a difference, if you listen to Larry Sasich, with the U.S. watchdog group Public Citizen in Washington, D.C. “You can sell hundreds of millions of dollars worth of a drug, even a bad drug, if you have the right marketing campaign,” he says.

Consumer advocates argue that pharmaceutical companies don’t advertise for the sake of public health but to push the latest disease and the latest brand of chemical treatment. While drug companies claim to be providing public health education in their messages, there are at least a few cynics out there.

Marcia Angell, a former editor of the New England Journal of Medicine, noted that drug companies “are no more in the business of educating the public about health than a beer company is in the business of educating people about alcoholism.”

Wherever you stand on the debate, you have to agree marketing diseases and drugs is not the same as marketing VCRs. With drugs, it is the completeness of the information that can mean the difference between life and death. Wouldn’t you want to know, for example, if the drug you see advertised is banned in another country because they found it was killing people? You won’t find this kind of information in a company-sponsored disease-awareness campaign.

One recent example is the diabetes drug Rezulin, which was banned in the U.K. in 1997 because of its tendency to produce severe liver toxicity. It was heavily advertised in the U.S. for over two years, with no mention of the U.K. ban. And then just last spring, the U.S. government yanked it from market because of the mounting death toll – it was indicated as the probable cause of nearly 400 deaths, 63 from liver failure.

Luckily for us the drug was never marketed in Canada.

For Canada’s sake, it pays for us to watch very closely what is happening in Europe. Unless someone can provide some clear evidence that there is a public health benefit in allowing drug companies to tell us how sick we are, we might want to ask for a second opinion before we allow more drug industry-fueled disease awareness to infect the Canadian airwaves.