I thought I saw them here (in Australia) but I must have seen them in New Zealand. NZ and the USA - the only two countries in the world to have DTC (direct to consumer) pharma information or advertising or propaganda...

http://www.innovations-report.de/htm...cht-28523.html

The Pros and Cons of DTCA

The drug industry argues that DTCA advertising helps 'educate' consumers of potential conditions and encourages them to see their doctor for diagnosis and treatment. While acknowledging that DTCA increases the amount spent on prescription drugs, they argue that in the long run early treatment and diagnosis reduces spending on other medical services, such as hospitalisation.

Critics of DTCA argue that the industry's advertising is primarily emotional in style and understates the adverse side-effects and as such is misleading. The imagery of the ads is appealing while the potentially serious side effects are buried in the fine-print. They also argue that the claimed health benefits are overstated. Surveys reveal that people who have seen DTCA ads will often request and be prescribed the drug. DTCA campaigns will usually aim to have pre-primed doctors via a parallel promotional campaign. Critics argue that this results in over-diagnosis of a condition and the inappropriate use of prescription drugs, even where non-drug treatments are as or more effective. As a result, DTCA unnecessarily drives up the overall cost of healthcare without necessarily improving the health of those treated.

A November 2006 report by the U.S. Government Accountability Office report noted that "studies we reviewed found that increases in DTC advertising have contributed to overall increases in spending on both the advertised drug itself and on other drugs that treat the same conditions. For example, one study of 64 drugs found a median increase in sales of $2.20 for every $1 spent on DTC advertising. Consumer surveys suggest that DTC advertising increases utilization of drugs by prompting some consumers to request the advertised drugs from their physicians, who studies find are generally responsive to these requests. The surveys we reviewed found that between 2 and 7 percent of consumers who saw DTC advertising requested and ultimately received a prescription for the advertised drug."

http://www.sourcewatch.org/index.php...er_advertising

Freedom of speech, commercial freedom, providing valuable information on new medicines to consumers, and countering medical paternalism are the main arguments put forward by the proponents of direct-to-consumer advertising. These are summarised in a paper by the New Zealand Marketing Association which also contains an interesting appraisal of the current Australian situation.1 Unfortunately, partial and unbalanced misinformation, which is the hallmark of New Zealand's direct-to-consumer advertising, is promotion clearly designed to drive choice rather than inform it.

Four years ago New Zealand general practitioners were abruptly awoken to the effectiveness of direct-to-consumer advertising. Overnight they had to cope with an unexpected and unwelcome increase in workload. Patients using the leading brand of beclomethasone appeared at surgeries in droves asking to switch to an orange inhaler (fluticasone), as a television advertisement had told them that their brown inhaler was to be withdrawn in a few weeks, to protect the ozone layer. In the view of many prescribers, the television advertisements contained several inaccuracies and raised patient anxiety unnecessarily as neither patients nor many general practitioners realised that generic beclomethasone would continue to be available. A senior company official would later admit that the timing of this campaign was chosen for marketing rather than environmental reasons. In particular, a generic equivalent to the company's inhalers was in the wings.

Many general practitioners were incensed at being pressured to switch well-controlled patients to what they considered to be a drug with little or no added therapeutic benefit.2 Perhaps more worrying, the longer-term health effects of a near doubling of average daily doses of inhaled steroids (many prescribers seemed unaware of the potency of fluticasone) are yet to be quantified.

There was also a significant increase in cost to the New Zealand taxpayer from the switch in prescribing driven by direct-to-consumer advertising. At the time, fluticasone carried a premium on the equivalent dose of beclomethasone. In addition, the increase in effective dose by many prescribers not making the 2:1 switch in dose increased this price differential and the overall subsided cost. The true cost will never be made public as there was a confidential, out-of-court settlement days before a Fair Trading Act case (initiated by the Pharmaceutical Management Agency of New Zealand to recover the costs to the health budget) was due to start in the High Court.

The increase in workload from the television campaign was exacerbated by the start of a counter direct-to-consumer advertising campaign by a rival company. This company promoted its own red combination inhaler which the advertisements assured would 'kick asthma' and 'work better than your brown or orange inhaler'. Some general practitioners reported patients with well-controlled asthma presenting in quick succession, first demanding to switch to the orange inhaler and then asking for the red one!

A very brief television campaign for oral terbinafine for onychomycosis resulted in a rapid doubling of national prescription sales. Some general practitioners reported several patients appearing in the same surgery demanding treatment for minimal nail discolouration. Many general practitioners gave up the unequal struggle of repeatedly spending 15-20 minutes explaining why prescribing a modestly effective, but very expensive (to the taxpayer) and potentially hepatotoxic, drug for a minor cosmetic problem broke most of the principles of rational prescribing. It is easier after all just to write the prescription and keep the patient happy. Indeed compliance with requests seems to be the common response. Surveys of consumer experiences both in New Zealand and in the USA consistently show that when a patient asks for a specific drug by name they receive it more often than not.3,4,5 This occurs even when the prescribers report they would not have prescribed the drug had it not been requested.3,4

In 2002, the heads of three of the four Departments of General Practice wrote to general practitioners setting out their intention to lobby for a ban on direct-to-consumer advertising and asking for colleagues to share their experiences. Within days more than half of all the general practitioners in New Zealand responded. The advertising and pharmaceutical industries were incensed and actively tried to discredit this advocacy.2 Four out of five general practitioners writing back felt negatively about direct-toconsumer advertising. This feeling is reflected in the statements supporting a ban issued by all of the main New Zealand health professional bodies and a number of consumer groups.3 The then Health Minister repeatedly stated a desire to heed this advice and to ban brand direct-to-consumer advertising.6 The New Zealand cabinet supported exploring this through the trans-Tasman harmonisation process. Whether that promise can be fulfilled may now rest with yet another round of public consultations.

We are what Strand calls a "self-medicated" society. Consumers do not actually write their own prescriptions, but they practically do, based on whatever drugs they see advertised on television. Strand writes, "Surveys reported in our medical literature reveal that when a patient comes into a doctor's office and requests a specific drug that he has seen advertised in the media, the doctor writes the exact prescription the patient requested more than 70 percent of the time!"

So, let's say that a consumer who has been feeling a little sad lately sees a commercial for the antidepressant drug Zoloft. The commercial demonstrates the symptoms for depression and the consumer identifies with them. Suddenly, he or she thinks, "I'm not just sad. I'm depressed, which is a 'medical condition that can be treated by the prescription drug Zoloft.'" With this in mind, the consumer goes to a medical doctor and says, "I've been really depressed a lot lately. I've been [the consumer recites the depression symptoms listed in the Zoloft commercial]. I think I need Zoloft." So, according to Strand, there's a 70 percent chance the doctor will prescribe Zoloft, the exact prescription the consumer requested. That's how pharmaceutical commercials really work. They directly influence consumer behavior, yet drug companies claim they only "educate" patients, but don't persuade them to do anything.

http://www.australianprescriber.com/...ne/29/2/30/2/#

http://www.newstarget.com/010315.html

[Perna]

The whole ad thing in the US has always been crazy, Alexandra. We have "Joe Camel" selling cigarettes to children and we're forever getting bombarded with beer ads, you have no idea how young and sexy and what a good life I have because I drink a certain kind of beer, LOL.

Most of us make fun of the ads I think; there aren't just mental health drugs being advertised but every drug and over the counter crap you can imagine and not in any particular order since it has to do with what a company will pay. So we get stupid "take this horse pill with 5,000,000 times the Vitamin X you need and you'll be happier than a pig in stinky, brown stuff!" right before or after an ad for a product to clean your bowels of the "accumulated" stinky, brown, stuff and then you get a med ad and as Jeff Foxworthy has joked, one of them had the side effect of "%#@&#! seepage" and that's not something someone wants to chance getting. I told my doctor I didn't want any drug where the side effect was "death" (which some asthma drugs actually have) so we don't just look at the drugs themselves and what they allegedly can do for us, we make fun of the people going from social isolation to being the life of the party and we pay attention to the side effects.

I think there's another side to the 70% as those people probably didn't go to the doctor at all before, didn't know there might be some hope or name to what they had or how to approach it. Look at the number of people who come here and ask questions about "what is this?" There's a lot of truth I think, at least here in the US, to the education thing drug companies do; they at least give a name to situations and maybe a hope where there wasn't one before. As you know, it often takes more than one drug to address a problem; I don't think there are a lot of people who just go to the doctor on a whim though; it's not fun in this country to go to the doctor :-) and through all the hassle. But all the other ads get ignored. I can tell you about pain relief, allergies, asthma meds, little purple pills, sleep meds, etc. (as well as programs to get all meds paid for/at reduced cost) but I am not affected by those because they're not "my" problem (though the asthma is, I have meds that work for that so don't pay much attention to the ads. I don't think I'm different from others?

But the advertising pays Perna.

> For example, one study of 64 drugs found a median increase in sales of $2.20 for every $1 spent on DTC advertising.

And then there were the examples that I cited above of clinicians in NZ being inundated with patients after an add advertising an asthma inhailer was aired. They said that many patients requested a shift to the new one DESPITE their asthma being well controlled.

I'd like to think that we could just laugh at the ads. But... They are changing consumers behaviour.

There was an example of discoloured fingernails too (a cosmetic problem). How people were given medications that weren't particularly effective and had potentially serious side effects because they saw an add on TV and asked for it by name. Took too long for the docs to tell the patient why they shouldn't have the med so most just gave it to them. That isn't helping. Those people would never have gone to the doc for that if it wasn't for the add.

I'm not sure what I think about promoting False hope. Especially when you didn't think there was really much wrong with you before seeing the add.