Some things never get old, and some things never get new.
What doesn’t get old is a very useful position paper prepared by the Canadian Treatment Action Council (CTAC) in 1999 on the issue of direct to consumer advertising (DTCA). The paper reaches the following conclusions:
- There is no evidence that DTCA leads to better health outcomes.
- There is no evidence about the costs of DTCA. Given the large sums of money spent on advertising, we can worry that these costs are calculated into the selling price of the medications that are on the market.
- There is evidence that DTCA negatively impacts doctors’ prescribing patterns and their relationships with their patients. Doctors will feel pressured by the advertising and by their patients’ requests to prescribe particular drugs, whether or not they are best suited for the particular patient.
- There is no evidence that DTCA will lead to better-informed consumers. It is by nature intended to promote a product, not to provide information about a competitor’s product that might be better suited to the patient’s needs.
These are only a handful of the conclusions from the paper, which is worth the read.
Before getting to the most recent campaign, let me cite the experience of another, where people who had been unable to tolerate a certain NNRTI went to their doctors to insist on having a prescription for that first “one pill once a day” HIV treatment, which contained the very NNRTI they had been unable to tolerate in the past. Who did that serve?
What about this newest campaign?
At first glance it has done a few things right: a broad variety of images of people used (there are actually a large number of versions of the billboard advertising with different images on them), and an emphasis on preparing questions to ask your doctor about treatment.
But it isn’t all that new, either. It still attempts to influence the consumer’s choice of treatment with very few words (most advertising that we bother to read will have very few words) and without balanced information about alternatives, or directions to where to get that unbiased complete information. In fact, I was quite horrified to see that if you go to the website associated with the campaign, you can indeed choose the questions you think are relevant to ask your doctor — there is even space to write in your own questions — but that list, when you go to print it, has a default file name of “Ask your doctor if [product name] is right for you” and you will see that same message at the top of the PDF document it produces.
I’ve talked to a number of pharmaceutical company representatives from different companies about their campaigns. I always ask them if they do an evaluation of the effectiveness of their campaigns, and the answer is always no. An evaluation would likely be as costly as the campaign itself, they say. So they blindly continue with their practices and then plead with the payers to reimburse their products at ever higher prices to cover the costs of developing them. And we all pay for that in the end.
By the way, in the images I have provided of the campaign, I have covered the name of the company and the product and I have substituted my own QR code. Mine will lead you to the CTAC paper, and not to the campaign’s website. I just could noy bring myself to promote the product or the campaign in writing about it. Oh, and to amuse myself, the photo from across the metro tracks (left) showing that the backlit ads cannot be captured in a photo from a distance…just like vampires!
What are the rules in Canada?
It would be easy to think that advertising is generally allowed here, as the US is one of two countries in the world that allow advertising of prescription medications and a lot of American media crosses our border.
The basic rule in Canada is that advertising may mention either the name of the product and the name of the company, or the condition that the product is intended to treat, but never both in the same advertising or in parallel advertising that creates a link. A company wanting to advertise “pre-clears” its ads through one of two private agencies that seem to have been mandated by Health Canada to ensure that the rules are followed.
In 2014, the absurdity of the regulation is clear: I can stand next to the billboard ad on my bus shelter and find out just what condition the product treats by looking it up on my smart phone and this in mere seconds. The fiction of the Canadian regulation “protecting” us from a free-for-all of pharmaceutical advertising is just that.
We need to end this expensive and useless practice now.