Drug Companies and the Media

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Drug Companies and the Media

• by
• Dr. Angus Robin Dr. Nabeela Hasan
• Bradford VTS 2008

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The Cynical Part of The Presentation

• Aims
• Look at types of Media drug companies use
• Does their use of media affect us?
• Advertising in Journals
• Quiz guess the advert
• Direct to Consumer Advertising

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Drug Companies Use of Media

• Reps
• Journal articles
• Supplements
• Ordinary Magazines
• Direct advertising to us patients
• Disease Awareness Groups
• Television
• Internet

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Ways Drug Companies Use Journals, Articles
Trials (1)

• Advertorials-advertisers may offer to buy
  advertising if it can be accompanied by
  favourable editorial mentions of their products
• Reprinting Trials- Drug companies spend money
  on reprinting well known, valuable trials put
  their adverts alongside them

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Ways Drug Companies Use Journals, Articles
Trials (2)

• The best trial asks a simple, medically important
  question, is properly randomised (to avoid bias),
  and is conducted on a large scale (to avoid
  getting the wrong answer by chance).
• BUT there are many ways to debase the process for
  marketing purposes.

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Ways to corrupt science to promote drugs

• Seeding and switching trials
• Postmarketing surveillance
• Equivalence trials
• Doses
• BMJ  20033261202-1205 

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Drug Adverts
We all flick through journals and medical papers
like pulse and see ads for drugs constantly. Do
you read them? Do you laugh at them / pity
them? Do you think they have any effect?
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Advertising

• Advertising - most obvious straightforward way
  in which drug companies use medical journals
• V. lucrative
• Many countries have many publications that are
  sent free to doctors entirely paid for by
  advertising.

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• Pharmaceutical advertising almost certainly does
  affect prescribing
• (Gottlieb S. Congress criticises drugs industry
  for misleading advertising. BMJ 2002325 137)
• Publishers have calculated a return on investment
  of drug advertising argued that it produces a
  better return than spending money on drug company
  representatives.

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Evidence that Drug Advertising Can Be Misleading

• A US congressional inquiry reported that from
  August 1997 to August 2002 the Food and Drug
  Administration (FDA) issued 88 letters accusing
  drug companies of advertising violations
  (Gottlieb S. Congress criticises drugs industry
  for misleading advertising. BMJ 2002325 137)
• In many cases companies overstated the
  effectiveness of the drug or minimised its risks.

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Disease mongering
Medicalisation of life was coined back in the
70s. Describes the widening of illness
boundaries to increase markets for treatments
(both the sellers and deliverers ie.
Us!). Healthy become patients. Wastes
resources. Iatrogenic harm. Professional and
commercial interests
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Recent BMJ piece
An American drug company is planning to release a
placebo called Obecalp. The idea came from
wanting to give a hypochondriacal child something
to calm down, and no placebos were in the drug
store. Cherry flavoured dextrose pill and
planning a liquid version next. BMJ  200833613
16 (7 June)
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So here follows a few drug ads most of us will
have seen. If you dont read the
BMJ/Pulse/Hospital Dr/GP than youll probably
still be able to guess what a few of these are
for. Try to think which type of drug? why
advertised like this? name of drug?
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What is Direct To Consumer Advertising?

• The promotion of prescription drugs by
  pharmaceutical companies directly to consumers
  via broadcast and print media such as television,
  radio, magazines, billboards, and also the
  Internet.

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Direct to Consumer Advertising

• Advertising non-prescription medicines to the
  public is permitted in the UK
• DTC advertising of prescription-only medicines is
  strictly currently prohibited in UK rest of EU
• Is allowed in USA NZ

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Direct to Consumer Advertising (2)

• In US , no. of scripts/person money spent on
  scripts rose dramatically BUT this did not
  correlate with improvement on health
• Has been recent pressure in EU Canada to lift
  ban
• Internet is not strongly policed so DTCA can
  occur in EU

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Arguments For DTCA

•  People want and need information on medicines
•  Advertisements will help people to get needed
  medical care at an earlier stage
•  Advertisements will lead to better compliance
•  A doctors prescription is needed, so the
  patient is protected.

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Arguments Against DCTA (1)

• Prescription drugs are not like other consumer
  goods. Even when used properly, they can cause
  serious harm
• People are vulnerable when they are ill
• Sick and worried patients are less likely to
  exercise critical judgment of varied information
  sources.
• Adding to medicalisation of conditions (pill for
  every ill)

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Arguments Against DCTA (2)

• Advertising increases patient pressure on doctors
  for reasons unrelated to medical evidence

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REMEMBER

• Advertisements aim to stimulate sales.
• They cannot provide impartial, objective
  information.
• Be wary of drug advertising drug reps!
• Say no to DTCA !

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• THE END