[Missing Credit][object Object] It is not surprising that those wanting a stop to direct-to-consumer advertising of prescription medicines are fed up. Every few years the issue is in the spotlight, often followed by a flurry of worthy political statements about it and then nothing happens. This month debate was reignited over an Advertising Standards Authority ruling on a complaint about a 30-second rotation digital billboard in Wellington featuring weight loss drug Wegovy. The authority found the billboard used a font too small for the mandatory information required for the advertising of prescription medicines to be read and understood by consumers. Of course, by the time the complaint was settled, the advertisement was no longer being run and the advertiser Novo Dordisk Pharmaceuticals agreed to make changes in future. There is so much media hullabaloo about weight loss drugs it might be easy to overlook that they are prescription medicines. But they are, and for good reason. Serious side effects from such medications can include prolonged vomiting and stomach paralysis, acute pancreatitis, gallbladder disease, and kidney damage from dehydration. University of Otago Emeritus Professor Les Toop, of the Department of Primary Health Care, has long been an advocate for banning direct advertising, and he points out the debate about it has been going nowhere for more than two decades. Political parties have from time to time expressed interest in making changes but never followed through. He says Labour had a longstanding policy of being opposed to direct-to-consumer advertising and had the opportunity to introduce it through the now repealed Therapeutic Products Act but dropped it at the last minute. Then it was hoped the incoming government’s Health Minister Dr Shane Reti would push for it, but that was also a non-starter. Prof Toop does not accept the freedom of speech argument for allowing the advertising. Among the countries we usually compare ourselves with, only New Zealand and the United States allow direct advertising, so other countries have found it reasonable to forego this free speech argument. The advertising does not necessarily mean those who might benefit most from a medicine achieve greater access. Instead, often it was those who would gain little if any benefit over their current treatment who were persuaded by a misleading advertisement, were assertive with their health provider and ended up being prescribed the medicine, he said. Overworked general practitioners, faced with demanding patients who want a particular medication, might find it easier to prescribe it rather than spend extra time fully exploring the pros and cons of it with patients. Prof Toop also points out the folly of creating demand for drugs that might cost thousands of dollars and asks what might not end up being funded as a result. It might be easy for consumers to believe these nice pharmaceutical companies are just helping them learn about new wonder drugs, but not every drug is a wonder drug. Even wonder drugs have side effects and reasons why some people should not take them. Nor are pharmaceutical companies philanthropic organisations. They are keen to make as much money as they can from any new medication they have spent money developing. Some years ago it was estimated the billions of dollars the US spent on direct consumer advertising was more than 10 times greater than the Food and Drug Administration's (FDA) budget to evaluate new drugs. In 2003, a group led by general practice professors reviewed the advertising in a report which called for a ban on it in New Zealand and the setting up of an independent medicine and health information service free of commercial interest. This service would provide information on the comparative risks and benefits of the drug and non-drug treatments for a condition. An advertising ban and this service seem more needed than ever with the current government keen to promote more patient involvement in Pharmac’s decision-making. We are not clear how it intends to protect any process from the increased risk of patient groups being captured by drug companies keen to flog their products. The failure of successive governments to do anything meaningful in this area says more about the power of the pharmaceutical lobby than the gumption of our politicians.
