UBC Reports | Vol. 48 | No. 5 | Mar.
Drug advertising may pose health risk warns researcher
Requests for advertised drug influence mds, says study
by Hilary Thomson staff writer
When marketing meets up with medicine, results can be harmful to
health, says a UBC researcher. Barbara Mintzes, a PhD candidate
in the Dept. of Health Care and Epidemiology, led a study of how
advertising affects prescribing practices in Vancouver and Sacramento,
The study was published last month in the British Medical Journal.
Doctors were more likely to prescribe a drug that a patient had
seen advertised and specifically asked for even when the doctor
was uncertain about its appropriateness for that patient, according
to Mintzes and co-investigators from UBC's Centre for Health Services
and Policy Research, York University and the University of California
"One of the big concerns about this kind of advertising is you're
pushing people to use very new drugs before we know very much about
either their risks or their longer term benefit," says Mintzes,
who has worked for Health Action International, a non-profit global
group interested in a more rational use of medicinal drugs.
The study of 78 primary care physicians and 1,431 patients used
questionnaires to determine the frequency of patients' requests
for prescriptions and of prescriptions resulting from requests.
Findings showed that physicians prescribe drugs in response to
almost three-quarters of requests and that doctors are ambivalent
about their prescription decision in about half of cases where they
are responding to patient requests for an advertised drug. They
reported ambivalence in only about one case in eight when not prompted
by a patient request.
The study looked at drugs having the 50 biggest advertising budgets
in the U.S. or which had been covered by Canadian media.
Only the U.S. and New Zealand allow advertising of drugs directed
at patients. U.S. pharmaceutical companies spent $2.5 billion US
in advertising prescription drug products to the public in 2000,
says Mintzes. Although this amount is less than 20 per cent of the
total advertising budget, it is the fastest-growing budget item,
she adds. Retail drug sales in 2000 totalled $145 billion US. The
Pharmaceutical Advertising Advisory Board, part of Health Canada,
prohibits such advertising but enforcement is lax, she says.
She points out that Canadians still get the messages through American
cable and satellite TV, magazines and the Internet. In addition
some ads are allowed that fall between the cracks of regulations
concerning promotion, such as disease-oriented ads that advise patient
to see their doctor.
"It's very clear that the industry has been pushing the limits
of the law," she says.
Even if it is not explicit, it is still promotional activity posing
as education, she adds. Critics of the research say it does not
address the key question of how the advertising-influenced prescribing
affected patients' health.
"Medicines have prescription-only status because they are judged
to be too risky to be used without the advice of a physician. We
are concerned that the protection offered by prescription-only status
is being seriously eroded if patients request drugs in response
to advertising and doctors prescribe requested drugs in spite of
being ambivalent about the choice of treatment," says Mintzes.
Visit the British Medical Journal Web site at bmj.com/cgi/content/full/324/7332/278