Monday, May 21, 2007

Drug Firms Fighting to Overturn Advertising Ban

Once again, the big pharma companies are flexing their muscles and threatening the EU unless it eases legislation on the industry. They are desperate to advertise their 'products' direct to the patient and they have drawn the support of various patient groups (which are in turn funded by the drug companies themselves) who believe that they have a right to choose which medication they are prescribed. We are heading towards very dangerous waters indeed. Although the idea of choice sounds wonderful, this is one of those cases where there is no such thing as 'choice', at least not an informed choice.I have two fundamental problems with the very notion of direct advertising borne out of my own experience with the drug industry. The first is cost, the second is knowledge. Allow me to explain.

First of all, let me paint you a picture of the current situation regarding advertising medicines and the subsequent costs. For some time now, drug companies have been able to advertise OTC (or 'over the counter') medicines in various forms. It is not unusual to see adverts for Calpol, Nurofen, Hedex on the television on an average day. One of the strongest OTC brands on the market is Panadol. Now, Panadol is essentially paracetamol. That's it, nothing more. The problem is that it has such a high level of recognition amongst the general public, many people ask for Panadol at the chemists for their headaches, colds etc. A pack of 16 Panadol tablets costs approximately £1.39 the cost of paracetamol (the active ingredient in Panadol) is substantially less than that. Nowadays, thanks to the 'wonders' of competition, you can pick up a pack of 32 paracetamol at your local chemists for approximately 65p. That is an amazing 74p difference, and you get twice as many tablets! And yet, they are exactly the same product. Only difference is, one is marketed as Panadol and one is marketed as a proprietary brand. And this, on a very small scale, is the problem that would be faced should the big pharmaceuticals get their way. POMs (or 'prescription only medications') are obviously far more expensive (in many cases) than OTCs. Imagine the difference in cost between a branded medicine and its generic equivalent. No matter that they are the same drug, the marketing campaign would ensure that a particular brand would stay in the patient's mind and encourage them to ask for that particular drug to be prescribed to them. This would clearly have vast consequences for the NHS. Whereas they would normally dispense the generic, cheaper drug, now they would have to dispense the more expensive branded drug. The cost to the NHS would be disastrous. But then, this is what the drug companies want anyway. The destruction of the NHS would ensure that their profits would reach previously unseen levels.

The other problem is the knowledge of the customer regarding the actual drugs themselves. I know many people think that they know everything there is to know about medication and various drug formulas. Well, I got new for you, you know jack shit. Why do you think doctors and pharmacists train for so long before they can prescribe or dispense these drugs? The general public only knows a fraction of the facts about the drugs they consume. However, it would be unfair to pin the blame for this solely on the consumer. Drug companies make it exceptionally hard for anyone to find out what the truth is about the drugs they manufacture, Even those who work in the health industry are not aware of all the facts about the drugs they issue. Take the case of Vioxx. The manufacturers Merck were found guilty of negligence in its
response to safety concerns about the painkilling drug. The reason for the safety concerns were because the drug wasn't fully tested. Imagine if Vioxx was backed by a huge advertising campaign. Just think how many people would have been affected if this was the case. This is where the problems begin. Even if the drug was properly tested, how could an average member of the public be able to disseminate complicated information about the drug trials and then make an informed choice? They can't. They will put their trust entirely in the hands of the drug companies. This is a very dangerous situation indeed. Doctors and pharmacists provide an important barrier between patient and drug company. The only people that can make judgements about the drugs we take are healthcare professionals (and even then they are still susceptible to financial inducements from the drug industry). I wouldn't have a clue about the effects of some of the POM medications that are on the market, and that's the way the drug companies like it. Our ignorance is their profit.

Make no mistake, a relaxation in the rules governing the marketing of POMs would have disastrous consequences. The NHS would be further crippled by the rise in the dispensing of branded drugs in favour of their generic equivalents. It is believed that the NHS could save more than £300m a year by prescribing generic over branded, imagine the consequences if the reverse were to happen. The result would be the final collapse of our national healthcare system. Furthermore, the inability for the patient to make an informed choice could also have disastrous consequences. Without having access to all the trial data, let alone be able to understand it, the patient would rely solely on the advice of the companies that produce the drugs. One thing is for certain, that are not going to put off potential customers, they have a business to run after all. In short, this move to ease regulations must be resisted at all costs. There is no telling how much long term damage this would do. The following is the conclusion of a report in the British Medical Journal about the 'Influence of direct to consumer pharmaceutical advertising and patients' requests on prescribing decisions':

Patients' requests for medicines are a powerful driver of prescribing decisions. In most cases physicians prescribed requested medicines but were often ambivalent about the choice of treatment. If physicians prescribe requested drugs despite personal reservations, sales may increase but appropriateness of prescribing may suffer. Concerns about the value of opening up the regulatory environment to permit direct to consumer advertising in the EU and Canada seem well justified.