DTCA (direct to consumer advertising)

I was surprised to discover that the only two countries in the OECD that allow direct to consumer advertising (DTCA) for prescription medications are the United States and New Zealand. I didn't notice it in New Zealand (and of course I'm not exposed to it in Australia) but I most certainly notice it on online forums...

There are pros and cons of course... The cons seems fairly overwhelming, however:

> Not surprisingly, in surveys of doctors the overwhelming majority say DTCA has had a negative impact on the doctor-patient relationship, and that they were being pressured to prescribe drugs they wouldn’t normally use. A study in New Zealand found 69% of responding GPs reported they had been under pressure from patients to prescribe advertised medicines. But of course doctors wouldn’t prescribe anything they thought was inappropriate or unnecessary, even if they were under pressure … or would they? A study of 24 British GPs found that almost half said they’d prescribed medicines they knew were ineffective, simply because they were expected to.

> The doctors acknowledged that the importance of the interpersonal aspects of the doctor-patient relationship — keeping on good terms — often overrode clinical judgement. It’s only a small study, but Australian doctors we spoke to agreed that many doctors want to keep their patients happy.

> Bear in mind also that for every unbranded ad campaign the public is exposed to, doctors are also being ‘educated’ about the products and getting promotions from drug company representatives. It’s been estimated that the drug industry spends on average around $1 billion per year in Australia — $21,000 per doctor — on drug promotions. While many doctors claim they’re immune to the effects of marketing, it’s effective enough for the pharmas to justify the expenditure.

one case study:

>Aurorix & Paxil:

> Social phobia (fear of social situations) is an anxiety disorder with government figures suggesting an estimated 370,000 sufferers in Australia in 1997, when Roche started promoting its antidepressant Aurorix (moclobemide) for its treatment.

> Roche (through its PR firm) issued a press release announcing more than one million Australians suffered from social phobia. A clinical psychologist was quoted strongly endorsing the role of antidepressants in its treatment.

> As an article in the British Medical Journal says, “All the media stories seemed to be part of an idea push to change the common perception of shyness from a personal difficulty to a psychiatric disorder.” That’s the crux of the objections to this type of campaign: the over-medicalisation of common and relatively minor problems.

> The publicity juggernaut took on its own momentum, with a newspaper article called ‘Too shy for words’ — reportedly not orchestrated by Roche — stating two million Australians suffered from social phobia.

> Interestingly there was a similar social phobia awareness campaign in the US in 1999, this time orchestrated by SmithKline Beecham (now GlaxoSmithKline) and its PR company, promoting an antidepressant drug Paxil (paroxetene, marketed as Aropax in Australia) as a treatment.

> Ads with the slogan “Imagine being allergic to people” appeared, with shyness and embarrassment turned into a life-crippling psychological illness. DTCA being allowed in the US, the drug could have been promoted directly to the public. However, the campaigners deliberately chose not to name the drug or the company, because that would have meant having to describe Paxil’s unpleasant side effects.

> Almost overnight social phobia became one of the most common mental illnesses in the US, affecting up to 13% of the population. US media mentions of social phobia increased from 50 in the years 1997 and 1998 to over a million in 1999. Paxil sales skyrocketed.

http://www.choice.com.au/viewarticle...tid=100008&p=1

Something to think about...

I suppose this site is allowed to do this as the server is located in the United States...