Collections under
which this article appears: Regulation
BMJ 2003;326:467 ( 1 March )
News roundup
Ban direct to consumer advertising, report recommends
Bob Burton Canberra
A report on direct to consumer advertising of prescription only medicines in
New Zealand has recommended that the practice be banned.
The report, by senior academic staff at all four of New Zealands medical
schools, concluded that such advertising, which is allowed in New Zealand, does
not give "objective information on risks, benefits and options to assist
patients to participate in healthcare decisions."
Professor Les Toop, from the University of Otagos Christchurch School of
Medicine and Health Sciences, and his five colleagues recommended that "an
independent health information service" be established to inform consumers on
health and treatment options instead of direct to consumer advertising.
Unlike in the United States, the only other developed country that allows
direct to consumer advertising, in New Zealand the health department does not
routinely monitor advertising. Complaints about advertisements are dealt with
under self regulatory codes run by either the advertising industry or the
pharmaceutical industry.
An appendix to the report gives the results of a survey of all 3200 general
practitioners in New Zealand. More than three quarters of the 1611 respondents
agreed that patients often asked for advertised drugs that were not appropriate
for them, while only 12% considered direct to consumer advertising to be useful
in educating patients about the risks and benefits of prescription drugs.
Although the report has gained broad support, including from the Royal New
Zealand College of General Practitioners, it has drawn some criticism. The
Communication Agencies Association, which represents advertising agencies,
dismissed the report as a "highly emotive attempt to stir unfounded concerns."
The Advertising Standards Authority, a non-governmental industry body,
complained to the University of Otago ethics committee that the survey was
misleading. After a preliminary review an investigator appointed by the
university dismissed the complaint as "vexatious."
The Toop reports conclusions are bolstered by documents from the
governments pharmaceutical management agency, Pharmac, obtained under the
Official Information Act by the Green Partys health spokeswoman, Sue Kedgley.
A November 2002 memo to the Pharmac board said that direct to consumer
advertising created "fiscal risk on the limited government pharmaceutical budget
as it drives up demand for subsidised pharmaceuticals, [and] shifts demand to
high-cost medicines by encouraging patients to move from older less expensive
medicines to newer high-cost medicines."
Pharmac reported that in 2001 $NZ4.9m (£1.7m; $2.7m; 2.5m) was spent on
direct to consumer advertising for the top four drugs. Dispensing volumes of the
four drugsfluticasone (Flixotide), terbinafine (Lamisil), omeprazole (Losec),
and eformoterol (Oxis)increased by 42% that year.
According to the memo a survey in February 2000 by Medsafea division of the
Department of Healthof regulatory compliance of direct to consumer drug
advertising found that "only 1 of the 6 (16.6%) of the television advertisements
was compliant with the [Medicines Act] regulations."
The Minister for Health, Annette King, remains non-committal on the reports
recommendations and has referred the report to departmental officials for
advice.
Direct to Consumer Advertising of Prescription Drugs in
New Zealand is available at
www.chmeds.ac.nz
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-- Albert Einstein, letter to a friend, 1901
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