A rchive Date
[ 15-02-2002 ]
Category
[ International Relations ]
sub-Categoy
[ Canada ]
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[http://www.canoe.ca/Health0202/14_ads-cp.html
Experts debate over soaring drug ads in U.S.
By HELEN BRANSWELL - Canadian PressTORONTO (CP) - Spending on direct-to-consumer drug advertising in the United States more than tripled between 1996 and 2000 as manufacturers of prescription drugs increasingly aimed their sales pitches past doctors to potential consumers.
Drug makers spent $2.5 billion US in 2000 to promote their drugs to American consumers, up from $791 million in 1996, said a study published Thursday in the New England Journal of Medicine.
Most drug promotion remains targeted at health-care professionals, whether through ads in medical journals or free drug samples for doctors.
But a rising portion of promotional budgets was funnelled into direct-to-consumer ads, which ate up nearly 16 per cent of those budgets in 2000 compared with nine per cent in 1996, the study said.
"This . . . may reflect the success of direct-to-consumer advertising in generating increasing sales, especially of high-priced drugs," said the study, written by Meredith Rosenthal and colleagues from the Harvard School of Public Health and the Massachusetts Institute of Technology.
The study didn't take sides on the controversial issue of whether drug companies should be allowed to pitch controlled products to consumers who lack the medical background to assess whether they need the drug.
But it noted that this advertising is having an significant impact on the practice of medicine. It pointed out an earlier study which reported that 71 per cent of family physicians said they believe direct-to-consumer drug ads pressure doctors into prescribing drugs they would not ordinarily prescribe.
Most of the advertising focuses on drugs that treat chronic conditions and could be sold to vast numbers of people. Anti-inflammatories (used to treat arthritis), antihistamines (for allergies) and antidepressants figured prominently in the list of the top 20 advertised drugs.
Direct-to-consumer drug advertising of the type seen on American TV networks is not allowed in Canada, although drug makers and media groups are pushing to have that ban dropped.
In this country, pharmaceutical companies have two options. They can tailor an ad around the name of a drug without stating what condition it is used for - which only works if the drug name is well known and its use is commonly understood. Or they can advertise a condition and suggest people who have it talk to their doctor, call a toll-free number or visit a Web site to learn more about how it can be treated.
Critics of drug ads directed at consumers argue that even these forms of commercials violate Canadian law and are pressuring Health Canada to crack down.
In both countries, there is an ongoing and bitter debate over direct-to-consumer drug advertising, which proponents claim merely educates the public and which opponents say is a blatant bid to increase sales.
The New England journal waded into the debate this week with a series of commentaries and editorials.
Dr. Alan Holmer of the drug makers group Pharmaceutical Research and Manufacturers of America argues that the aim of drug ads is to educate the general public.
He also argues that critics who say these ads interfere with a doctor-patient relationship are wrong. If a patient who has been too embarrassed to talk about a problem or who thinks there is no help available is actually spurred to seek treatment from a doctor, that can only help the relationship, Holmer said.
Dr. Sidney Wolfe of the Washington-based Public Citizen Health Research Group disputed drug company claims that the purpose of the ads is to educate. He notes studies pointing out that the public doesn't understand the ads, and that they believe only the safest and most effective drugs can be advertised this way (there is no such criteria).
"The education of patients - or physicians - is too important to be left to the pharmaceutical industry, with its pseudo-educational campaigns designed, first and foremost, to promote drugs," Wolfe argued.
Meanwhile, Drs. Thomas Lee and Troyen Brennan of Harvard Medical School note that direct-to-consumer ads have moved beyond drugs to diagnostic screening procedures such as CT-scans and MRIs.
Healthy U.S. consumers are being told they can undergo such procedures - for a fee - to give themselves the peace of mind that comes from knowing they are healthy.
But the value of some of these tests for screening purposes hasn't been proven - there is ongoing debate over the value of mammograms, for instance - and the rate of false positives can be high. Those come at a cost to both the consumer and the health-care system that must then investigate, Lee and Brennan write.
"The likely outcome of widespread use of such tests is that a greater proportion of patients would worry unduly about disease and undergo further unnecessary testing."
Journal editor Dr. Jeffrey Drazen said that regardless of whether direct-to-consumer ads are good for the system, they are likely, in the United States at least, here to stay. And so he urged doctors to help patients put them in perspective.
"We need to remind our patients that what they see and hear in the mass media is simply advertising. Although advertising does inform patients, it should not be confused with medical advice given in the best interest of the patient by a learned intermediary."
 World Fact Book (CIA)]
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