Advertising Medicines
Web Mistress (that still sounds a bit rude) Carol Kirshner has just alerted me to something very important.
It looks as if there is going to be more oversight of direct-to-consumer advertising of medicines.
She posted this on Thursday:
"According to an article published today by Reuters the General Accountability Office (GAO) has published a report that the Food and Drug Administration (FDA) needs to improve their monitoring of direct-to-consumer drug advertising. Specifically, the FDA should issue warning letters more quickly when misleading advertisements appear.
The GAO findings are based on an examination of 19 letters issued in 2004 and 2005 which took, on average, 8 months to send out. The GAO asserts that by the time the companies received the letters, most had already discontinued the ads. Additionally, the GAO found that even after the letters were received, some companies continued to break the rules on the same medications.
The GAO report found that the pharmaceutical industry spent 4.2 Billion dollars on DTC ads in 2005. This is almost double the amount spent in 1997. Breakdown of other spending includes 7.2 Billion dollars promoting directly to doctors and 31.4 Billion dollars spent on R&D.
Logic would seem to suggest that if spending on DTC advertising continues to grow exponentially, monitoring will become even more difficult. There will simply be too much volume to keep up with given the current resources of the FDA. In fact, the FDA has tried to proffer this as an explanation for the lapses. According to the article, the GAO is standing firm that the FDA could do more."
The first thing to say is that the vast majority of pharma companies do a great job of providing clear and accurate information, and I know of several for whom patient welfare always trumps the bottom line. But clearly there have been some problems.
Second, is that consumers need to be aware that the inofmration in the advertisements may no longer be 100% accurate, so check before you take anything. One of the reasons for creating this blog was so that I could be responsive to questions and quick to provide new information as it appears.
I also have a number three point, and it is something that surprises many of my friends and colleagues in the United States. Direct-to-patient advertising is prohibited almost everywhere else in the world. The rationale for that prohibition is most definitely not to disempower people! It is that careful prescribing of medicines is becoming an ever more complex art and science.
Regular readers may remember a report about the lamentable level of training of British doctors in how to prescribe and combine medicines. And British doctors do not have the added burden of patients asking for medications by name.
Some years ago I was at a meeting at which I was told a statistic that 92% of American doctors will prescribe a medicine if tha patient asks them to, while the figure throughout Europe was less than 20%. I’ve never been able to find any documentation for those figures, though they were given to me by a senior executive in a pharma company.
If those figure are anywhere near the truth they would worry me: there are just so many inter-individual differences in response to treatment and so many potential interactions between medicines, herbs and supplements. Explaining them all to someone who hasn’t been trained in phamacology can be tough.
Trust me! I’ve been teaching medical students, residents, junior attendings, pharmacists and nurses since the 1970s. All have biomedical backgrounds, but teaching them all the ins and outs of modern pharmacology can be a Labor of Hercules!
So this is absolutely not a criticism of members of the public asking about things that they have seen on TV or the internet. Neither is it a criticism of 99% of the pharmaceutical industry.
I think that it’s great for people to ask for what they want, the problem is this: How many doctors and nurses are able to say no?
And also to explain their reasons clearly?
Isn’t it just an extra stressor for patients and prescribers alike?