Healthy Skepticism Library item: 6351

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Publication type: news

Graydon S.
A second opinion
Marketing Magazine 2006 Oct 23
http://members.marketingmag.ca/login.jsp?t=http://www.marketingmag.ca/magazine/current/opinion/article.jsp%3fcontent=20061023_71073_71073#

Full text:

October 23, 2006
Marketing

A second opinion

By SHARI GRAYDON

Media companies shouldn’t cast their desire for drug advertising as a
freedom of speech issue

What do creaky knees have to teach Canadians about the perils of
privileging corporate free speech over consumer health and safety?

Direct-to-consumer advertising (DTCA) of the arthritis pain drug Vioxx is
estimated to have contributed to the deaths of 10,000 Americans. In fact,
closer to 40,000 died from heart attacks attributed to the arthritis
medication. But the ad campaign was believed responsible for only a quarter
of Vioxx sales.

That’s small consolation to Merck Frosst. On the receiving end of thousands
of lawsuits, the drug maker is likely to be tied up in court for years. Even
if you don’t suffer from arthritic joints, or hope to provide advertising
space to prescription drug makers, the lesson learned is a sobering one.

And yet media and pharmaceutical companies alike are salivating over the
prospect of CanWest Global Communications Corp.‘s success in challenging the
Canadian laws prohibiting DTCA on this side of the border. Since the U.S.
loosened its own restrictions in 1997, prescription drug ad spending has
increased dramatically. Last year it hit almost US$5 billion.

But line up the evidence pro and con DTCA and it’s easy to understand why
only two jurisdictions in the industrialized world allow it. And New Zealand
is having second thoughts.

Advocates of DTCA argue consumers have a right to information about new
medication. But DTCA is notoriously lousy at delivering impartial and
objective information. The FDA has found that such ads regularly minimize
drug risks and exaggerate their benefits. They fail to reveal the likelihood
of treatment success, or the available alternatives. In short, the
information in drug ads doesn’t help consumers make informed choices. Nor
does it facilitate diagnosis, improve the quality of prescription drug use
or reduce hospitalization.

DTCA is, however, enormously successful at moving product. It encourages the
rapid adoption of new drugs before their longer-term risks are fully known.
It increases the likelihood that healthy people, or those with mild forms of
common illness, will turn to drugs, and it increases the rate at which
doctors write prescriptions in response to patient demands.

DTCA defenders counter that physicians shouldn’t be prescribing drugs simply
because patients ask for them. No kidding. But the unfortunate reality is
that when widely disseminated promotional material engages patients in
simplistic analyses of their health problems, it’s more difficult for
doctors to insist that older and cheaper drugs-or no drugs at all-are the
preferred course.

The cost factor alone has huge public policy implications. Should CanWest be
successful in its charter challenge, consumers and the health-care system
would end up paying through the nose.

Based on the U.S. experience, the allowance of DTCA in Canada would generate
an additional $1.1 billion in drug costs in the first year alone. The
increase would come from both the volume of drugs prescribed and the
reliance on newer, more costly medications. DTCA also causes more people to
request doctors’ appointments for conditions that they didn’t previously see
as a problem.

Take sleeping pills, for example. Prescriptions for sleeping medication in
the U.S. shot up 60% between 2004 and 2005, largely due to aggressive ad
campaigns for Ambien and Lunesta. And yet research shows that one in six
people over 60 using sleeping pills suffers harm, and only one in 13 does
better than someone on a placebo.

Canadian media consumers are already seeing DTCA on American networks and in
U.S. publications. That’s unfortunate. It’s a symptom of the inadequate
enforcement of our existing law.

As regrettable is the decision by Health Canada to permit “reminder” ads
(which include a drug’s brand name, but no health claims or risk
information) and “help-seeking” ads (which refer to a condition only, and
encourage sufferers to consult their doctors). Both of these contravene the
spirit of Canada’s Food and Drug Act, which explicitly, and for good reason,
forbids DTCA.

Dressing up the pursuit of increased profits in freedom of speech rhetoric
doesn’t hide the fact that DTCA represents a threat to Canadians’ health and
safety, a menace to our already fragile health-care system, and arguably a
lapse in ethical judgment.

Lawmakers and responsible corporate citizens alike should be looking for
ways to protect Canadian consumers, not jeopardize them for commercial gain.

SHARI GRAYDON is an Ottawa-based communications consultant and the author of
Made You Look-How Advertising Works and Why You Should Know.