Influential body urges ban on gifts at US medical schools

The NY times reports that the Association of American Medical Colleges has drawn up a model policy that would ban drug companies from offering free food, gifts, travel and ghost-writing services to doctors, staff and students in all 129 of the nation’s medical colleges. In the past most medical colleges have implemented recommendations made by the Association.

The policy seeks to deal with the conflict of interest and and inappropriate influence that drug companies have when the get involved with the education of future medical proffessionals.

Interestingly the task force that drew up the model policy had a number of representatives from the industry, itself including the chief executives of Pfizer and Eli Lilly

India - possible cap on drug promotion

The Economic Times in India reports that the government is set to cap the promotional expenses of pharmaceutical companies. The move is part of a package of measures aimed at reducing the cost of medicines.

The paper reports that "minister Ram Vilas Paswan said on Wednesday that a panel comprising officials from the centre, state and industry representatives will examine introducing a ceiling on promotional and marketing expenses of companies, which now drive up retail prices."

Consumers Union awarded $4.4 million to give free unbiased information.

Consumers Union in the US has been awarded a $4.4 million grant to support a public education program designed to eliminate huge gaps in public knowledge about prescription drugs.

The grant will help expand the availability of free unbiased prescription drug information to counter the $10 billion spent on advertising in the US by drug companies each year.

The grant money is available as part of a $38 million dollar consumer protection settlement between the Attorneys General of 50 states and Warner-Lambert, now owned by Pfizer. In 2004, Warner-Lambert agreed to pay $430 million to resolve allegations that it illegally marketed its drug, Neurontin®, for "off-label" purposes not approved by the Food and Drug Administration.

US state moves closer to banning all gifts to doctors

The Massachusetts's senate has passed a bill that would ban all gifts to doctors by 36 - 0. The bill will now pass to the House of Representatives and Governor who will have to give their approval before the bill is passed.

The Boston Herald reports that the bill was drawn up as part of a series of measures to curb spiralling health care costs and has attracted fierce opposition from industry lobbyists.

If passed, the Massachusetts' bill will go beyond laws in other states in that it will ban all gifts - not just gifts above a certain value.

A clear warning!

Consumer International's spoof 'Pharma TV' ad gives an idea of what could happen if countries that currently ban Direct to Consumer Advertising are persuaded to remove the ban or water it down.

This article, written by Michael Wilkes, M.D, a professor of medicine at the University of California, is a clear warning to any decision maker who is thinking of weakening regulations on Direct to Consumer Advertising. It gives the financial and health arguments for keeping the ban and rubbishes the idea that adverts in the US are effectively monitored before being aired.

With moves in Canada and the EU to weaken the ban on direct to consumer advertising, it's a timely warning.

Generics and brands - a Sri Lankan view

The Sri Lankan press has been hosting a heated debate about the relative merits of generics and brands. This article from the Sunday Times in Sri Lanka takes a step back and stresses the importance of independent, accurate and up to date information about drugs.

However, the situation in Sri Lanka is far from ideal with the Sri Lanka Hospitals Formulary not having been updated since it was first published 14 years ago - way back in 1994. There is another document available, the Sri Lanka Drug Index, however it is now four years old and hasn't been updated.

According to the Secretary of the Government Medical Officers’ Association, Dr. Anuruddha Padeniya, the lack of up to date and independent information is leaving GPs in the hands of the drug companies and their promotional material. This can make 'some, not all, prescribers more familiar with particular brands than generics.'

The health ministry has promised a National Drug Information Centre and to produce updates on their website.

Psychiatric drug ads 'frequently misleading'

Chemistry World reports on a new US study that found over a third (35 per cent) of the claims made in a sample of psychiatric drug ads were not supported by their cited sources.

The article in Chemistry World claims that '42 out of the 53 ads (nearly 80 per cent) the researchers examined made at least one claim the team couldn't substantiate. 27 made a claim that was not supported by the data source cited by the ad. A further 15 contained claims that couldn't be verified by the team - usually because the ads provided no sources of data to back up their claims, or made claims that could not be verified because drug firms either failed to respond to the researchers' requests for trial data, or refused to supply it.

Six out of nine pharmaceutical companies - including GlaxoSmithKline, Pfizer, AstraZeneca and Shire - did not reply to the researchers, while Wyeth refused to send trial data.'

The report claims the FDA doesn't have the resources to effectively check drug ads. The authors claim that just 21 FDA officials at the agency's Division of Drug Marketing, Advertising, and Communications were charged with reviewing over 39,000 adverts aimed at doctors in 2005. Anti depressants are the most prescribed drugs in the US.

Pharma vs. generics (again)

Another example of a pharma marketing campaign undermining the market for generics – this time from Spain.

In October OCU, the Spanish consumer organisation criticised a marketing campaign funded by Farmaindustria (the National Association of Spanish Pharmaceutical companies.) The campaign involved a shabby, unlabeled, unbranded bottle of pills and the slogan “brands are important indeed.”

OCU accuses Farmaindustria of trying to make a link between unbranded medicines and generics and thereby weaken consumer confidence in generics.

OCU complained to the Spanish Drug and Health products Agency as well as the Health and Consumer Ministry but while recognising the inappropriateness of the campaign, the Pharma General Directorate invited OCU to take legal action but did nothing to stop the campaign themselves.

Online drug advertising set to increase

New figures from Direct Marketing News show that US drug companies' Internet advertising expenditure is set to reach nearly $173 million by 2012, up from an expected $93.6 million this year.

For anyone concerned about the impact of drug marketing this is a worrying trend. Not only is Internet advertising notoriously difficult to regulate, but the fact that the Internet knows no borders means that drug marketing that is permitted on US sites can also be viewed in countries where direct to consumer advertising of prescription drugs is banned.

Although sites can carry a message saying that the information is only intended for US citizens this is unenforceable and probably only increases viewers' curiosity.

The cost of wining and dining doctors down under

A recent report from Medicines Australia tells how 42 of Australia's drug companies spent $16.4 million on travel, accommodation and hospitality for doctors in the six months to December.

The report, the first of its kind in Australia, was produced on the orders of the Australian Consumer and Competition Commission and covers spending on educational events for doctors. Whilst you may have expected transparency to curb some of the industries' excesses there are still some high spending events included in the report. AstraZeneca, for instance, spent $514,000, including $226,000 on hospitality, on a national symposium for 226 gastroenterologists in Melbourne - $2,275 a head based on total event costs (and a whopping $1,000 per head on hospitality!) Other big spending events are mentioned in this article from the Herald Sun.

In an interview with ABC, Choice - the Australian Consumer organisation - said the report was an illustration of how the industry seeks to influence doctors and called for greater support for independent sources of information such as the National Prescribing Service.

Whist the Medicines Australia report focuses on the drug companies expenditure its also worth remembering that drug companies' influence at these events is not limited to the quality of the venue and the accommodation. This article from the BMJ highlights how drug companies are also involved in the vetting and filtering of conference speakers.

When is a drug ad not a drug ad?

The answer, according to EC’s latest consultation paper on the issue, is when it’s ‘non-promotional information’.

The European Commission’s draft proposals on drug information provision are causing quite a stir. Not least because the process of deciding what constitutes ‘information’ rather than ‘advertising’ appear so heavily skewed towards the pharmaceutical industry.

This consultation is a significant point in the debate about direct to consumer advertising of prescription drugs.

Consumers International has come out strongly against the EC’s suggested approach with an official response to the consultation. CI argues the EC is opening the door for the drugs industry to push prescriptions drugs directly to consumers in Europe.

It is vital that the concerns of European consumers are considered if we are to avoid sleepwalking towards US-style drug advertising, disease mongering, and the dreaded Pharma TV.

These concerns have also been raised by the British Medical Journal. The BMJ’s assistant editor Tessa Richards drew attention to the dangers in a comment piece in the March ‘08 edition:

“Many argue that allowing the drug industry to use the internet, radio, and television to propagate messages about its products is tantamount to opening the promotional floodgates”

The full editorial is well worth a read for a fuller understanding of what the EC’s drug promotion consultation actually means.

You can also get a snap shot of the issues from the three-minute Marketing Overdose film – Pharma Facts: Informing the Public, featured above.