Drug advertising claim provokes retort

A claim that direct-to-consumer drug advertising is a constitutional right drew a fiery response from two GPs at the New Zealand Bioethics Conference in Dunedin yesterday.

Apart from the United States, New Zealand is the only developed economy to allow the controversial practice of marketing pharmaceuticals to consumers .

Christchurch-based healthcare strategist Dr Nicola Rowe told delegates that while she was not advocating for drug advertising, it was protected under freedom of expression in the Bill of Rights. She said there was scant evidence to support commonly levelled claims that drug advertising harmed patients, and increased health system costs. The argument it pressured GPs to prescribe more drugs did not justify a ban, as it was their job to be ''gatekeepers'', and not cede to every patient demand.

She believed the role of drug representatives visiting GPs to promote their wares was a far bigger influence on prescribing.

Responding to Dr Rowe's talk, Dunedin GP Dr Katharine Wallis pointed out that she had a policy of declining to meet drug representatives, so they were not influencing her prescribing decisions. Her patients were influenced by advertisements, which created ''illness in the minds of people''. Drugs were sought for ailments that used to be seen as part of the ageing process, or simply part of life itself. A drug's side effects could outweigh its benefits, and these had to be explained to patients. Whangarei GP David Bawden also opposed the adverts, saying GPs were at times ''bombarded'' by patients wanting drugs.

He believed side effect warnings were more explicitly stated in advertisements in the United States, where there was increased risk of litigation. In New Zealand, adverts were typically presented by a well-known figure ''glossing over'' possible side effects. It meant New Zealanders were at increased risk from drugs that caused problems in their first few years on the market, he said. Without public awareness of a newer drug, GPs might otherwise be wary of prescribing them for the first few years.

Dr Rowe said she was not defending the practice, but simply pointing out it was probably a ''constitutional right'' under New Zealand law.

- eileen.goodwin@odt.co.nz

NZ should get rid of DTCA

It's also my constitutional right to expect to be told the truth by Big Pharma about the products they peddle so both clinicians and I can make fully informed decisions about any medications I am offered. How can this happen when Big Pharma consistently refuse to openly disclose full research trial data for peer-reviewed scrutiny, or even to Regulators when seeking approval to market their products? They exhibit little or no social responsibility, despite their claims otherwise, and their bottom-line interest is maximising profits, even when research evidence clearly shows some of their products may be causing more harm than good.

Direct-to-consumer advertising (DTCA) imprints the message of a pill-fix for everything & rarely adequately signals the cautionary indications. The wider the disease definition & its indications they promote the more drugs they sell. It's not in Big Pharma's interests to advance health promotion and prevention strategies that avoid reliance on medical solutions in the first place.  Allowing DTCA in NZ is one of the worst health decisions we've ever made.

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