Ask your doctor

Direct-to-consumer adverts and disease awareness campaigns all carry the line 'ask your doctor.' Now Altroconsumo, the Italian consumer organisation, has adopted the phrase, but for a slightly different purpose.

Faced with what it describes as 'a lack of transparency and relentless marketing' from the pharma industry, Altroconsumo says consumers should learn to ask their doctor three questions when prescribed a new drug.

1) How does it work and what purposes does it serve? is there a generic equivalent?

2) What are the side effects?

3) Are there alternative medicines with lesser side effects?

Probably not the sort of questions that the pharma companies and marketing teams were thinking of!

US senators challenge companies on DTC ads

Last week drug companies in the US were again asked to explain their marketing campaigns to senators concerned about the misleading nature of some of their ads. The committee's hearing comes amid growing signs that the Democrats want to step up the scrutiny and regulation of drug marketing.

The committee focused on three advertising campaigns each of which highlighted a different area of concern.

• Merck and Scherings were asked why they continued to run advertisements for Vytorin even though a study had concluded that it was no more effective than a low cost generic.
• Pfizer was questioned over an advertisement for their cholesterol drug Lipitor that featured claims from a doctor who was not a licensed physician.
• Johnson and Johson was criticised for its Procrit ads that made claims that had not been approved by the regulators.

All the advertisements were eventually withdrawn by the companies.

Marketing tactics

Anyone that has seen a few DTC drug ads will be familiar with the rapid fire listing of side effects that appears as a rushed after thought at the end of the ads, but it seems that's not the only method drug companies use to distract the consumer from the information they need. Enter a hyper active bumble bee...

At a recent senate panel hearing Ruth Day, head of Duke University's Medical Cognition Laboratory, drew attention to the activities of the bumble bee in an ad for Schering-Plough's allergy drug Nasonex.

When the voice over was listing the benefits of the drug the bee quietly hovered so the viewer could concentrate on what was being said, but when it was time for the side effects the bumble bee set off, busily flying around the screen.

"All of these wing flaps and wing flashes and sparkly things essentially divided the attention of the viewers ... and thus led to decreased knowledge" of possible risks, Day said.

Sales - and safety concerns - in emerging markets

According to the International Herald Tribune Big Pharma are seeing rapid sales growth in emerging markets - and they expect the trend to continue.

However whilst this may be good news for their shareholders, it raises serious concerns for anyone concerned by unethical marketing practices. Many of the countries that are helping to maintain these companies' profit margins do not have the regulatory capacity that is found in more developed economies. This can lead to blatant breaches of regulatory standards and codes.

To read more about the risks of increased drug marketing in countries with low levels of effective regulation see 'Doctors, Drugs and Dinners, how drug companies influence health in the developing world.'

GSK warned on disease awareness campaign

According to the Straits Times, the Singaporean authorities may be having a rethink about their decision to allow drug companies to run disease awareness campaigns. And if the latest example is anything to go by, you can see why. The GSK advert is certainly heavy on the scare tactics and light on details.

The caption opposite the man and child in the advert here says "Honey, we will miss you everyday. Happy Birthday."

The Health Sciences Authority listed a series of shortcomings in their complaint about the advert including:

• It does not list the symptoms of cervical cancer.
• It does not mention risk factors associated with the disease.
• It does not tell women about ways to detect the disease early.
• It plays on emotions, and uses fear as a tactic.
• While it does not tout a vaccine against cervical cancer, it said: 'Cervical cancer can be prevented. Find out more about how you can protect yourself from the virus that causes cervical cancer.'

Sloppy journalism does Big Pharma's dirty work

A 29 April article in the lifestyle pages of the Sydney Morning Herald delighted in the launch of the new one-a-day Erectile Dysfunction (ED) drug, Cialis:

‘No more popping a pill an hour before a romantic meal or making a booking with the wife. Now the 40% of older Australian men who have trouble getting an erection can take a tablet every morning that will make them ready for sexual intercourse without having to plan ahead.’

Direct to consumer advertising of prescription drugs is banned in Australia, but with mouth-piece journalism like this, why would drug companies need to bother? Not only is the article taken chapter and verse from the Eli Lilly press release (makers of Cialis), but the claim that a new study shows 40% of Australians could do with taking the drug is ridiculous.

The figure comes from ED research (commissioned by none other than Eli Lilly) which asked 410 men aged 45-64 about their sex life. Just over 160 of them said their ability to have “spontaneous sex” had declined in their 40s. This is spun by Eli Lilly and trumpeted by the Sydney Morning Herald as reason to believe the older Australian male population are crying out for help with ED.

Reduced sexual activity in older men is NORMAL. It does not automatically mean there is a medical condition and certainly doesn’t mean men in their 40s need to be taking Cialis everyday (and at AUS$170 a month, its not cheap).

The price of Cialis is not the only thing to make you think twice. Not mentioned in the article and buried at the bottom of Cialis website is info on unconfirmed side effects including possible loss of hearing and vision. Now that’s something that would really sour the moment!
This is disease mongering at its most unpalatable. One has grown to expect it from drug companies like Eli Lilly, by a reputable broadsheet like the Sydney Morning Herald should know better than to do the dirty work for Big Pharma.

For more deplorable marketing tactics from the pharmaceutical industry, check out the Marketing Overdose film Pharma Confidential below:

Influential body urges ban on gifts at US medical schools

The NY times reports that the Association of American Medical Colleges has drawn up a model policy that would ban drug companies from offering free food, gifts, travel and ghost-writing services to doctors, staff and students in all 129 of the nation’s medical colleges. In the past most medical colleges have implemented recommendations made by the Association.

The policy seeks to deal with the conflict of interest and and inappropriate influence that drug companies have when the get involved with the education of future medical proffessionals.

Interestingly the task force that drew up the model policy had a number of representatives from the industry, itself including the chief executives of Pfizer and Eli Lilly

India - possible cap on drug promotion

The Economic Times in India reports that the government is set to cap the promotional expenses of pharmaceutical companies. The move is part of a package of measures aimed at reducing the cost of medicines.

The paper reports that "minister Ram Vilas Paswan said on Wednesday that a panel comprising officials from the centre, state and industry representatives will examine introducing a ceiling on promotional and marketing expenses of companies, which now drive up retail prices."

Consumers Union awarded $4.4 million to give free unbiased information.

Consumers Union in the US has been awarded a $4.4 million grant to support a public education program designed to eliminate huge gaps in public knowledge about prescription drugs.

The grant will help expand the availability of free unbiased prescription drug information to counter the $10 billion spent on advertising in the US by drug companies each year.

The grant money is available as part of a $38 million dollar consumer protection settlement between the Attorneys General of 50 states and Warner-Lambert, now owned by Pfizer. In 2004, Warner-Lambert agreed to pay $430 million to resolve allegations that it illegally marketed its drug, Neurontin®, for "off-label" purposes not approved by the Food and Drug Administration.

US state moves closer to banning all gifts to doctors

The Massachusetts's senate has passed a bill that would ban all gifts to doctors by 36 - 0. The bill will now pass to the House of Representatives and Governor who will have to give their approval before the bill is passed.

The Boston Herald reports that the bill was drawn up as part of a series of measures to curb spiralling health care costs and has attracted fierce opposition from industry lobbyists.

If passed, the Massachusetts' bill will go beyond laws in other states in that it will ban all gifts - not just gifts above a certain value.