Healthy Skepticism Library item: 8485

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

Hopkins H.
Misuse is why drugs are controlled by prescription
The Australian 2007 Feb 10Health
http://www.theaustralian.news.com.au/story/0,20867,21198085-23289,00.html

Full text:

ADVERTISING prescription medicines direct to consumers is illegal in Australia, so one side benefit for pharmaceutical companies of having a drug reclassified from “prescription only” to “pharmacist only” or “pharmacy medicine” is that the drug can then be advertised, potentially expanding its market.

This happened to the weight loss drug Xenical, initially available only on prescription, which in 2004 was rescheduled as a “pharmacist only” drug and in 2006 given limited advertising approval.
However, this may be short-lived. The classification of Xenical will be re-considered next week after complaints from consumer groups and the general public that it was being promoted as a weight loss solution to people for whom the drug is not recommended, including young people under 18 where the safety of Xenical has not been established.

These complaints focussed on the advertising of Xenical during television programs targeting young people. The advertisements have now been withdrawn after they were found to breach the advertising code for medicines. But not before they were seen by the estimated 1.3 million viewers of the popular Australian Idol program, including many who were aged under 18.

Obesity is a serious health problem and losing excess weight can be difficult. So why not promote a drug that can help people lose weight, along with dietary and lifestyle changes?

Xenical is only recommended for use in certain people who are overweight and obese. For most people who want to lose weight, such as young people under 18, people who are slightly or moderately overweight (but not obese) and women who are pregnant or breastfeeding, Xenical is not the answer.

Promoting Xenical through mass media advertising can create a misleading expectation that it is suitable for anyone who wants to drop a few kilos. It can also undermine the message that dietary and lifestyle changes are the most important strategies when trying to lose weight.

Of course pharmacists are supposed to screen consumers inquiring about Xenical and provide them with information about the importance of eating a low fat diet to minimise side effects, and being physically active. Unfortunately we don’t know how regularly this occurs in practice.

Are pharmacists asking for proof of age before dispensing Xenical to teenagers? Are people whose body mass index is below that suitable for Xenical being sent away with information about how to improve their lifestyle instead? Can consumers asking their pharmacist for advice on weight loss treatments be confident they are receiving informed, objective, unbiased information?

There is a reason why we don’t allow doctors to sell medicines to their patients. It is to remove the potential for doctors’ advice on treatment options to be influenced by an ability to profit from prescribing drugs.

The same rule should apply to pharmacists. It is not a matter of the trustworthiness of individual doctors or pharmacists but a broader issue of consumers’ confidence in the advice they are receiving. Pharmacists can make more money by selling customers weight loss medicines than by telling them to eat well and do more exercise. That fact alone undermines the perception that the advice they provide is objective and guided only by the best interests of consumers.

The makers of Xenical argue that they have put substantial resources into developing a drug that has been approved by Australian regulatory authorities as safe and effective. Unlike other products on the market that claim to help people lose weight, Xenical has been evaluated to show that it actually works. Therefore, why should Xenical be discriminated against by having its availability restricted to “prescription only” while competitor products can be freely sold in supermarkets and pharmacies?

Perhaps Xenical’s manufacturers have a point, but protecting the interests of drug companies should come a good second in our regulatory system to ensuring consumers have access to accurate, objective and comprehensive information. A re-scheduling of Xenical back to “prescription only” would go a long way towards helping consumers make an informed choice about weight loss drugs in the context of finding the best weight loss strategy for them.

Helen Hopkins is executive director, Consumers’ Health Forum of Australia