Case to challenge direct to consumer advertising of drugs in Canada
Pharma’s pushing pills. Photo by Day_C
The Toronto Star ran an article yesterday about a new study in the New England Journal of Medicine that has added further details in the debate about Direct to Consumer advertising of prescription drugs, showing unsurprisingly that it has increased dramatically (spending has increased by 330%) over the past decade. The study is timely with the pending reauthorize the Prescription Drug User Fee Act.
From lead author Julie Donohue, Ph.D., assistant professor of health policy and management, GSPH:
“Our analysis found that the trend toward increasing spending on direct-to-consumer advertising is likely to continue and efforts to enforce more stringent guidelines on such practices would require not only significant changes by the pharmaceutical industry but by the FDA as well.�
From the Press Release:
Their analysis found that the pharmaceutical industry’s total real spending on drug promotions almost tripled – from just over $11.4 billion to almost $30 billion — between 1996 and 2005. They also found that the overwhelming majority of drug advertising was targeted to physicians. However, over the past nine years, spending on direct-to-consumer advertising and free samples has risen as a share of the total promotion budget, whereas promotional investment in professional journals fell. Real spending on direct-to-consumer advertising increased by 330 per cent from 1996 to 2005 and made up 14 per cent of total promotional expenditures in 2005 compared to less than 9 per cent in 1996.
There is also a Canadian connection to this story. Donahue is an expert witness for CanWest Global Communications in their legal challenge of Canada’s ban on prescription drug advertising. The challenge is now before the Ontario Superior Court.
These results are unlikely to sway regulators in the US, who have a much higher regard for freedom of speech and freedom to advertise by businesses. Evidence of harm due to advertising is notoriously hard to demonstrate.
In Canada, pharmaceutical companies are permitted to either advertise the name of a drug, without making any claims about its use, or advertise a medical condition and remind readers, listeners or viewers that if they have this condition they can seek help from their doctors. If Canwest Global’s challenge is successful, things could change considerably for how Canadians learn about drugs.
Kevin currently manages initial client engagements with the MaRS Venture Group. He also administers a federal fund that provides mentorship to start-up companies across Ontario.
Nice job pulling together the article and its background. The link to the author and CanWest was very relevant.
The issue of DTC drug advertising in Canada is very complex. The environment that currently exists was formed in the vacuum created by lack of coherent policy. It would be useful to have the federal government step up and take a leadership position relative to this issue.
In my opinion the lack of consistent funding of new drugs in Canada; primarily the fault of the Provincial governments, has created a situation where DTC campaigns, whether by “advertising” or by “advocacy” are a necessary part of a product’s promotion. This favours “Big Pharmaâ€?, as it has the deep pockets to support such programs.
In the case of expensive drugs, as in oncology, until a patient appears on the front page of the Globe the debate is hidden in the bureaucratic drawers of the Provincial Health Ministries. For “lifestyle� drugs, such as drugs to treat ED, the provinces don’t believe them to be medically useful, so the consumer demand is the only real recourse for the promoting companies.
I’m generally in favour of DTC advertising, and not just because it may create more jobs for Market Research and Advertising agencies! The Pharmaceutical Advertising Advisory Board has become a voracious force in controlling the messages that doctors see. There’s no reason to believe they would be any less uncooperative with DTC advertisers.
My opinion is not shared by all, however. A good link to a recent paper disagreeing is: http://www.openmedicine.ca/article/view/23/26. I’m not convinced that Mr Morgan’s argument holds water, given the extreme differences in funding of drugs in Canada vs. the US, but the analysis is a useful contribution to the debate.
Keep up the good work, Kevin!
Posted by: Steve Willson on August 22nd, 2007 at 3:17 pm
DTC (direct-to-consumer) Advertising is one of the most controversial practices the drug industry uses to market its various products.
Total spending on pharmaceutical promotion grew from $11.4 billion in 1996 to $29.9 billion in 2005. Although during that time spending on direct-to-consumer advertising increased by 330%, it made up only 14% of total promotional expenditures in 2005. Direct-to-consumer campaigns generally begin within a year after the approval of a product by the FDA.
Supporters of this form of advertising, which is banned in nearly almost all countries (excluding the United States and New Zealand) say it provides a real service to consumers, informing them of new drugs and alerting them to health problems they may be unaware of.
Critics feel this form of advertising promotes only the most expensive new blockbuster drugs, when older and cheaper versions of drugs might be just as effective, thus driving up overall health care costs, with much emphasis placed on the high costs of prescription drugs.
Aggressive promotion can pay off big time. Merck, maker of Vioxx, the most promoted drug, spent $161 million advertising it in 2000, and sales of Vioxx quadrupled to $1.5 billion.
In fact, Merck spent more advertising Vioxx, according to NIHCM (National Institute for Health Care Management Foundation), than the $125 million spent promoting Pepsi or the $146 million spent on Budweiser beer ads. It even came close to the $169 million spent promoting GM’s Saturn, the nation’s most advertised car.
The drug industry says its ads not only educate consumers but also prompt people who might otherwise go undiagnosed to see their doctors. Many doctors agree.
What’s your opinion as to whether or not prescription drug advertising costs are a direct reflection to the high costs of prescription drugs in the United States.
Posted by: William Hill on January 13th, 2008 at 9:55 pm