WOULD you want to see Prozac advertised routinely in Britain鈥檚 newspapers,
magazines or on TV? For more than two years, the Association of the British
Pharmaceutical Industry (ABPI) has been pushing to change the law to allow
鈥渄irect-to-consumer advertising鈥�. In other words, marketing to the public what
are currently prescription-only medicines. And with scarcely a hint of debate,
the deal could be done before we know it.
鈥淚s change necessary?鈥� asks the ABPI in a recent briefing paper for the
media. Yes, it replies to its own question: 鈥淧harmaceutical companies wish to
provide accurate, balanced, scientifically based and ethically sound information
about their medicines directly to the public to meet growing demand.鈥�
Think about the effect advertising and drug promotion to professionals has
had on prescribing standards and you鈥檒l get the general idea. Instead of
following their clinical judgement, today鈥檚 doctors face, and sometimes succumb
to, advertising pressure.
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Direct-to-consumer advertising was virtually unheard of until 1997, when the
US Food and Drug Administration bowed to pressure and changed its rules. The
floodgates opened. Now companies in the US are spending some $2 billion
every year on direct-to-consumer advertising, the rate of growth is still
phenomenal, and pharmaceuticals companies are reaping huge returns on this
investment. Now the industry is pushing hard for legalisation in Europe and the
rest of the world鈥攁nd the European Commission began 鈥渃onsultations鈥�
earlier this year.
An article published this summer by Pharmaceutical Marketing paints a picture
of the behind-the-scenes frenzy describing a briefing given by the ABPI to the
Pharmaceutical Marketing Society. 鈥淭he ABPI battle plan is to deploy ground
troops in the form of patient support groups, sympathetic medical opinion and
healthcare professionals . . . which will lead the debate on the informed
patient issue. This will have the effect of weakening political, ideological and
professional defences . . . Then the ABPI will follow through with high-level
precision strikes on specific regulatory enclaves in both Whitehall and Brussels . . .鈥�
So much for all the nonsensical and patronising talk about ordinary people
being transformed into 鈥渋nformed consumers鈥� or 鈥渆xpert patients鈥濃�攁s if
advertising alone could cut through the complexities and educate the average
citizen. If the industry were even halfway serious about informing people about
drugs, it would start by pushing for companies to disclose fully their
dealings with the regulators鈥攏otably the evidence on which they base their
applications for product licences.
The limited debate so far has been dominated by talk of alleged benefits.
What of the risks of this kind of advertising stimulating unsustainable demand
for certain drugs? What will it do to the price of drugs, budgets and access to
medicines? How would massive advertising budgets affect editorial independence?
And would the barrage of 鈥渄isease awareness鈥� campaigns reduce us in time to a
nation of healthy hypochondriacs?
This type of advertising feels to me like the product of the American system
of private medicine. It鈥檚 a system that delivers conspicuously poor value for
money and is completely beyond the reach of some 40 million of citizens in the
US. Direct-to-consumer advertising is seriously incompatible with what national
health and community well-being were meant to be. The founders and staunch
supporters of Britain鈥檚 NHS will be horrified by it.