Medical Ethics - Advertising
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Medical Ethics and Advertising
General Information
NEWS:
A Bitter Pill to Swallow "FTC officials said part of the reason consumers fall for phony weight-loss claims is because they see advertisements in major publications like TV Guide, Men's Fitness and People magazine."
(Almost) Everybody Does It "Almost every doctor in the country has some type of relationship with pharmaceutical manufacturers, whose clear goal is to influence physicians to prescribe the company's newest, most expensive drugs. The companies offer physicians everything from scratch pads to trips worth thousands of dollars to attend medical conferences. But which doctors receive the biggest perks? A new study appearing this week in the New England Journal of Medicine reveals that it varies with the type of practice, the medical specialty, the patient mix and the doctor's professional activities. … Were you surprised at the findings? I was surprised at the sheer percentage of physicians who have financial relationships with the drug industry. Ninety-four percent of all physicians have these relationships. Most commonly, it's things like receiving free samples of drugs or receiving food and beverages which may be consumed by their staffs. But a third of physicians are reimbursed for costs associated with professional meetings or CME [compulsory classes in "continuing medical education"]. About a quarter are paid to serve on advisory boards, work as consultants or enroll patients in clinical trials."
Baby milk ads 'should be banned' "The National Childbirth Trust, Save The Children and Unicef blame adverts for many mothers abandoning breast feeding before the recommended six months. They want the government to extend a ban on infant milk adverts to include "follow-on" milks for older babies. "
Biased Breast Cancer Studies From Drug Companies? "When the pharmaceutical industry funds studies on breast cancer, the results are more likely to be positive, according to the results of a new study. New research from the University of North Carolina School of Medicine in Chapel Hill also reveals industry-funded studies have significant differences in design compared to non-sponsored trials."
Bristol-Myers Squibb Fined Again "Bristol-Myers Squibb is paying the government more than half a billion to settle charges that the company inflated the prices of its drugs, paid kickbacks to doctors and promoted its anti-psychotic drug Abilify for unapproved uses."
Direct-to-Consumer Advertising in Oncology: A Content Analysis of Print Media "Conclusion: Oncology print DTCA is prevalent in cancer-related, patient-directed magazines, and infrequent in the popular press. The information presented is considerably difficult to read, raising important questions about the appropriateness of direct-to-consumer marketing for oncologic medications."
Direct-to-consumer advertising under the radar: the need for realistic drugs policy in Australia "Direct-to-consumer advertising of prescription medicines (DTCA-PM) is currently banned in Australia. DTCA-PM is thought to increase health-care costs by increasing demand for drugs that are both expensive and potentially harmful. However, DTCA-PM is occurring in Australia despite the current prohibition. We argue that successful regulation of the practice has been undermined as a result of changes brought about by the ongoing communications revolution, the increasing centrality of patient choice in medical decision-making and the impossibility of drawing and maintaining a sharp distinction between information and advertising. The prohibition is further threatened by recent international trade agreements."
Doctors Reap Millions for Anemia Drugs "Two of the world’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients’ risks of heart attacks or strokes."
Doctors’ Ties to Drug Makers Are Put on Close View "There is nothing illegal about doctors’ accepting money for marketing talks, and professional organizations have largely ignored the issue. But research shows that doctors who have close relationships with drug makers tend to prescribe more, newer and pricier drugs — whether or not they are in the best interests of patients. "
Drugmakers, Doctors Get Cozier: Gifts Continue, Contacts Increase Despite Guidelines "Despite efforts to curb drug companies' avid courting of doctors, the industry is working harder than ever to influence what medicines they prescribe, sending out sales representatives with greater frequency and plying physicians with gifts, meals and consulting fees, according to several new papers. … In the survey period, drug representatives met with family practitioners an average of 16 times a month, with cardiologists and internists nine or 10 times a month, with pediatricians eight times a month and with surgeons four times a month."
Every Clinician Deserves an Un-Sales Rep
FDA Announces Results of Investigation Into Illegal Promotion of OxyContin by The Purdue Frederick Company, Inc.: Company Misrepresented Prescription Pain Reliever to Health Care Professionals "The U.S. Food and Drug Administration's (FDA) Office of Criminal Investigations (OCI) announced today that The Purdue Frederick Company, Inc. has agreed to pay more than $700 million to resolve criminal charges and civil liabilities in connection with several illegal schemes to promote, market and sell OxyContin, a powerful prescription pain reliever that the company produces. An investigation by OCI uncovered an extensive, long-term conspiracy by The Purdue Frederick Company, Inc. to generate the maximum amount of revenues possible from the sale of OxyContin through various illegal schemes. To further this goal, Purdue trained its sales representatives to make false representations to health care providers about the difficulty of extracting oxycodone, the active ingredient, from the OxyContin tablet; trained its sales force to represent to health care providers that OxyContin did not cause euphoria and was less addictive than immediate-release opiates; and allowed health care providers to entertain the erroneous belief that OxyContin was less addictive than morphine."
Financial ties link some docs, drug companies "A groundbreaking Minnesota law is shining a rare light into the big money that drug companies spend on members of state advisory panels who help select which drugs are used in Medicaid programs for the poor and disabled."
FTC fines 4 diet pill manufacturers "The Federal Trade Commission on Thursday fined the marketers of four weight loss pills $25 million for making false advertising claims ranging from rapid weight loss to reducing the risk of cancer."
Ghost authorship of industry funded drug trials is common, say researchers "Ghost authorship, whereby someone who has made a major contribution to a scientific article as an author is not acknowledged, is a widespread practice, says a study published this week. In the clinical trials investigated in the study, three quarters of individuals who had made significant contributions to the final paper were not listed as authors (PLoS Medicine 2007;4:e19). In most cases these were statisticians working for the company sponsoring the trial. "
Industry-funded breast cancer trials show more positive results. (Int J Health Serv. 2007)
Kraft is Sued for Falsely Calling Capri Sun Drink 'All Natural' "The suit contends that the company's deceptive marketing tricks consumers into thinking the product is healthier than it actually is, perhaps encouraging some people to confuse the almost juice-less drink with real fruit juice. Though high-fructose corn syrup (HFCS) is no more harmful than other sugars, it is a plainly man-made ingredient, according to the nonprofit Center for Science in the Public Interest (CSPI), which, alongside the Florida law firm of Varnell & Warwick, is representing the plaintiff in the class action suit."
Minn. Psychiatrist Quits Drug Panel "Financial relationships between the drug industry and two panel members, including Simon, came to light when The Associated Press reviewed disclosure records filed by drug companies under a pioneering state law. Eli Lilly & Co. and other drug makers paid Simon more than $350,000 in honoraria and fees while he was serving on the Minnesota Medicaid Drug Formulary Committee. Another adviser who resigned last year got $78,000. The Minnesota Department of Human Services is asking the panel members to sign off on a new policy requiring them to reveal "real or perceived" conflicts of interest, including honoraria, compensation, free travel or other perks from drug companies within the past five years."
OxyContin maker misled on addiction risks "Purdue learned from focus groups with physicians in 1995 that doctors were worried about the abuse potential of OxyContin. The company then gave false information to its sales representatives that the drug had less potential for addiction and abuse than other painkillers, the U.S. attorney said."
Pfizer schizophrenia drug ad misleading: US FDA "The FDA said the Pfizer ad included some information about potential side effects from injectable Geodon but failed to list "other serious warnings and precautions." Specifically, the promotion failed to mention the possibility of neuroleptic malignant syndrome, tardive dyskinesia, hyperglycemia and diabetes. In addition, the ad implied Geodon was more effective than a generic drug, haloperidol, "when this has not been demonstrated by substantial evidence or substantial clinical experience," the FDA said. "
Posing as pals, drug reps sway doctors' choices "As much as doctors would like to deny it, subtle attention from friendly drug sales representatives can have a big impact on what drugs they prescribe, according to two U.S. studies published on Monday."
Psychiatrists, Children and Drug Industry’s Role "… the intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics. These best-selling drugs, including Risperdal, Seroquel, Zyprexa, Abilify and Geodon, are now being prescribed to more than half a million children in the United States to help parents deal with behavior problems despite profound risks and almost no approved uses for minors. A New York Times analysis of records in Minnesota, the only state that requires public reports of all drug company marketing payments to doctors, provides rare documentation of how financial relationships between doctors and drug makers correspond to the growing use of atypicals in children. From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold. … Such payments could encourage psychiatrists to use drugs in ways that endanger patients’ physical health, said Dr. Steven E. Hyman, the provost of Harvard University and former director of the National Institute of Mental Health. The growing use of atypicals in children is the most troubling example of this, Dr. Hyman said. "
Risking kids to sell fish: An ad campaign encouraging pregnant women to eat seafood is a case study in industry-driven 'research.' "… timely and accurate information is crucial for those who want to make healthy and affordable choices. … For years, the Food and Drug Administration and the Environmental Protection Agency have advised women who are pregnant, might become pregnant or are breast-feeding to eat no more than 12 ounces weekly of any type of fish or shellfish that could be high in mercury, a potent neurotoxin. … But it's hard to stop a powerful, if troubling, marketing strategy once commercial interests take over. The National Fisheries Institute… paid the travel expenses of the researchers who generated the report for the National Healthy Mothers, Healthy Babies Coalition and gave each of them … The misleading report is a classic example of industry-driven marketing under the cloak of scientific research. Fortunately for consumers, however, the FDA and EPA have just repeated their strong stance on the dangers posed by overconsumption of certain fish, which should help derail the effort to promote sales over children's health. … And the selective repackaging of science, combined with slick marketing to sell more fish to pregnant women and women of childbearing age, show the height of corporate irresponsibility. This is one fishy marketing scheme that consumers should throw back."
To Break the Disease, Break the Mold "Another aspect of the problem is our peer review system for financing research. It works well at eliminating poor investments, but it squelches innovation and fosters the old boy network."
TV Drug Ads Too Emotional, Study Shows "Television commercials for prescription drugs play on viewers' emotions, often lack solid information, and downplay the role of a healthy lifestyle, according to a new study. But the pharmaceutical industry begs to differ; industry spokespeople saying the study is flawed because it relies on information gathered before new guidelines to improve the commercials took effect."
Watchdog Asks FDA to Stop Celebrex Ad
ARTICLES:
Confronting Medical Errors in Oncology and Disclosing Them to Cancer Patients "Oncologists face unique challenges in caring for cancer patients that may contribute to the risk of medical errors and to the difficulty of disclosing them to patients. The complexity of most cancer treatments, involving the use of different antineoplastic agents along with concurrent medications and supportive therapies, can make it especially difficult for oncologists to determine whether an adverse event was a result of treatment toxicity, a treatment adverse effect that was more severe or different than expected, or the result of a medical error.15 The use of detailed chemotherapy protocols makes harmful errors less likely, whereas the need for multiple concomitant medications increases the possibility of their occurrence."
Doctors and Drug Companies — Scrutinizing Influential Relationships "But physician–industry relationships can also have serious negative effects. For example, doctors with ties to industry may be more inclined than their colleagues to prescribe a brand-name drug despite the availability of a cheaper generic version. The provision of free samples may reinforce this behavior and perhaps stimulate off-label use of medications, which can pose risks for some patients. Industry relationships may stimulate the premature adoption of novel treatments, which could lead to serious health problems for patients. Industry inducements may reduce physician adherence to evidence-based practice guidelines in favor of company medications or interventions that are not recommended in independently developed guidelines. Finally, the financial rewards from industry relationships may reinforce a culture of entitlement among physicians, which could limit their ability to honestly acknowledge and manage the potential negative effects of these relationships."
Drugs, Doctors and Dinners: How drug companies influence health in the developing world
Is consumer health information by drug companies trustworthy?
Is it insulting to suggest that health professionals are influenced by drug promotion?
Pharma money: the least common denominator
Pharma money: we can do better "What the evidence tells us is that the information doctors receive from pharmaceutical companies omits important safety information, promotes increased prescribing, increases costs of prescribing and results in less rational prescribing."
Time to Ban Direct-to-Consumer Prescription Drug Marketing "It is time to ban direct-to-consumer (DTC) advertising of prescription drugs. The current US system of pharmaceutical company self-monitoring and Food and Drug Administration oversight is not working. Moreover, it cannot realistically be expected to work. A ban is needed to protect the public's health and the quality of health care. It is time to ban direct-to-consumer (DTC) advertising of prescription drugs. The current US system of pharmaceutical company self-monitoring and Food and Drug Administration oversight is not working. Moreover, it cannot realistically be expected to work. A ban is needed to protect the public's health and the quality of health care."
What everyone needs to know about drug marketing Part 1: Products
What everyone needs to know about drug marketing Part 2: Prices
What everyone needs to know about drug marketing: Part 3 Place, Promotion and Goals
What have we learnt from Vioxx?
JOURNAL ARTICLES:
Aged, Frail and Denied Care by Their Insurers "Yet thousands of policyholders say they have received only excuses about why insurers will not pay. Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult — if not impossible — for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. … 'The bottom line is that insurance companies make money when they don’t pay claims,' said Mary Beth Senkewicz, who resigned last year as a senior executive at the National Association of Insurance Commissioners. 'They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.' … But policyholders have lodged thousands of complaints against the major long-term-care insurers. A disproportionate number have focused on Conseco, its affiliate, Bankers Life, and Penn Treaty.. … By comparison, Genworth Financial, the largest long-term-care insurer, received only one complaint for every 12,434 policies."
Claims in advertisements for antihypertensive drugs in a Dutch medical journal. (J Hypertens. 2007) "CONCLUSIONS: Overall, 35% of the advertisements for antihypertensive drugs contained suggestive claims not supported by the offered evidence. The current system of self-regulation cannot ensure that pharmaceutical promotion is always accurate, balanced and evidence-based."
Creating demand for prescription drugs: a content analysis of television direct-to-consumer advertising. (Ann Fam Med. 2007) "CONCLUSIONS: Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters that have lost control over their social, emotional, or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes. The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health."
Direct to Consumer Advertising in Healthcare. (Clin Orthop Relat Res. 2007)
Pharmaceutical Company Payments to Physicians (JAMA. 2007) "Conclusions The Vermont and Minnesota laws requiring disclosure of payments do not provide easy access to payment information for the public and are of limited quality once accessed. However, substantial numbers of payments of $100 or more were made to physicians by pharmaceutical companies."
Schizophrenia, drug companies and the internet. (Soc Sci Med. 2007) "Fifty eight percent of the websites analysed received funding from drug companies. Drug company funded websites were significantly more likely to espouse bio-genetic rather than psycho-social causal explanations, to emphasise medication rather than psycho-social treatments, to portray 'schizophrenia' as a debilitating, devastating and long-term illness, and to link violence to coming off medication. They were neither more nor less likely to describe 'schizophrenics' as violent. These results suggest that the documented influence of the pharmaceutical industry over research, professional organisations, teaching institutions, clinical practice and regulatory bodies may now extend to public promotion, via the internet, of perspectives conducive to maximisation of sales."
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