Eli Lilly UK TV ad accused of breaking the rules

Consumers International have complained to the Presciption Medicines Code of Practice Authority about an Eli Lilly TV campaign that they say is effectively breaking the rules that ban direct to consumer advertising in Europe.

Eli Lilly's '40 over 40' campaign was launched in the UK in July with the aim of raising awareness about erectile dysfunction in men over 40 and urging those concerned to make an appointment with their doctor. The campaign is the first UK targeted campaign of this kind to appear on British television.

Under UK rules, direct to consumer advertising of prescription drugs is not allowed, however 'disease awareness campaigns' are. Of course it's a mute point where 'awareness raising' stops and 'advertising' starts. Sales of Eli Lilly's erectile dysfunction treatment will presumably increase as men watch the TV ad and obediently make appointments with their doctor to discuss their sex lives.

The rules seek to preserve the dubious distinction by requiring that disease awareness campaigns are 'non-promotional' and 'Any information provided ... must not be made for the purpose of encouraging members of the public to ask their doctors or other prescribers to prescribe a specific prescription only medicine.'

Of course Eli Lilly have not mentioned the name of their product in the TV advertisement or the associated website, however in other respects the company has done what it can to push their product over other treatments.

Firstly the company's logo appears on the TV advertisement and on every page of the associated website. Type 'erectile dysfunction' and 'Eli Lilly' into a search engine and it takes less than 30 seconds to identify the name of the company's product.

Not content with that, the treatment page on the website goes further. Eli Lilly have skirted the problem of not being able to name their product by instead referring to it as 'product 1' and placing it at the top of the list of options. Perhaps unsurprisingly the information given about each product suggests 'product 1' is preferable on most criteria when compared with other treatments.

Visitors to the site are then urged to see their doctor and discuss their 'preferences' - a packet of 'product 1' perhaps?

Consumers International run http://www.marketingoverdose.org/

Stanford medical school restricts industry funded medical education

Stanford School of Medicine has joined other premier schools across the US in further restricting the influence that the drug industry has on medical education. According to the San Fransisco chronicle the latest restrictions mean that the school will no longer allow drug and medical device makers to control the content of continuing education programs they fund at the school.

In the article Dr. Philip Pizzo, dean of the Stanford medical school, said continuing education can only be free of commercial influence if its curriculum is independent from industry funding.
"So much of that is actually directed toward changing prescribing patterns," he said.

Stanford's medical school received $1.87 million, or 38 percent of its funding for continuing medical education courses, from industry in 2006-07. Industry funding nationwide rose from $302 million in 1998 to $1.2 billion in 2006, according to a study cited by the university.

While pharmaceutical companies say they don't dictate the content of the programs they fund, said Dr. Brian Hurley, president of the student association, in reality they do control the outcome. "Pharmaceutical firms will only fund speakers who give favorable messages on the products they're trying to sell," he said.

Stanford Medical School's news release is available here.

Australian GPs bombarded with promotional material

Doctors in Australia are being bombarded with promotional material from drug companies, according to Choice, Consumers International's member in Australia. In contrast independent providers of information about drugs are barely getting their foot in the door.

The survey of 180 practicing GPs found that doctors were receiving an average of seven visits from drug reps every month plus a mountain of promotional material. Additionally 40% of the doctors in the survey had been sponsored by a drug company to attend a conference, seminar or training session. However only half of the doctors were even aware of the government-funded National Prescribing Service (NPS), an independent nonprofit organisation for quality use of medicines.

Doctors who report weekly contact with drug reps have been found to be more likely than those who have less frequent contact to prescribe drugs without first checking for published clinical evidence of effectiveness

Choice is calling for more support for independent sources of information about drugs and an independent body to monitor drug promotion.

The story was covered in The Australian and on ABC.

Drug companies' educational grants are 'well targeted marketing.'

Drug companies are accused of spending millions sending doctors on all expenses paid trips to medical conferences according to the Guardian newspaper in the UK. Consumers International, who run the Marketing Overdose campaign, described the practice as 'highly effective, well-targeted marketing.'

The article follows a survey of drug companies' disclosure by Consumers International that showed that none of the major drug companies has made a global commitment to disclosing their educational grants. Some US based companies have committed to disclosing their US grants following pressure from US senator Chuck Grassley. In Australia drug companies give details of their spending to a public register.

Consumers International wrote to the European Federation of Pharmaceutical Industries and Associations (EFPIA) on 2 July calling for greater disclosure of drug companies' financial support for medical organizations, educational events and financial arrangements with health care professionals, but has yet to receive a response.

Call for a new independent regulator in Australia

Choice - the Australian consumer organisation - has called for a new independent regulator and independent drug detailers to help tidy up drug marketing practices in Australia.

The Choice report 'Pushing Pills' looked at advertisements that appear in doctors' magazines and concluded that they were both misleading and tended to promote new and expensive drugs rather than long standing, cheaper but also effective treatments.

In 2006, when the Australian Competition and Consumer Commission (ACCC) approved the latest version of the Marketing Code, written by the self regulatory body Medicines Australia, the ACCC Chairman Graeme Samuel concluded, "it is unclear how effective [the Code] is in actually regulating drug companies' conduct". Unfortunately, the law does not allow the competition regulator to make major changes to the Code.

Belgian rules on drug advertising to be tightened

A recent BMJ article reveals the Belgian government’s decision “to strengthen existing controls” on drug advertising after an advertisement was challenged by Test Achats, the Belgian consumers organization.

In Belgium, it is illegal to advertise pharmaceutical products where the costs are reimbursed through the social security system. However, the law is unclear when an “advertisement refers only to an illness and not to a drug”. Rudy Demotte, the public health minister, stated the new legislation would grant the future committee the “power to scrutinise all public health advertising and information campaigns” to clear up any future uncertainty.

Test Achats clashed with Hodie Viveres, a non-profit public health foundation, over an advertisement on the “public dangers of athlete’s foot”. Test Achats claimed the advertisement was in effect promoting the drug Terbinafine. Terbinafine is a refundable drug under the social security system and was used to treat 80% of cases of athlete’s foot in 2002.

South Africa – attacks on generics

The National Association of Pharmaceutical Manufacturers (NAPM) in South Africa has successfully challenged three companies (Jansen Cillag, GSK and Pfizer) for undermining the market for generics.

Following a challenge from NAPM, Jansen Cillag were found guilty by the Advertising Standards Authority of South Africa (ASASA) for an advertisement entitled ‘illusion’ that NAPM said contained a ‘misleading and disparaging argument aimed at creating doubt in the minds of readers about the safety, quality and efficacy of generics in South Africa.’

NAPM has also had a successful ruling at the ASASA against GSK for material sponsored by the company that ASASA believed undermined confidence in generics.

Finally NAPM has also successfully challenged a leaflet produced by Pfizer Laboratories (Pty) Ltd that NAPM said created misperceptions about generic medicines and confusion for both health care professionals and the patients.

The NAPM complaint was upheld by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), however - to date - there is no information on the IFPMA website as to what penalty Pfizer Laboratories (Pty) Ltd received.