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It is difficult to understand why New Zealand has allowed direct-to-consumer advertising of prescription medicine (DTCA) for so long.
Concern about the impact of such advertising, allowed under the Medicines Act 1981, is nothing new, but somehow there has been no political will to ban it.
Many New Zealanders may love to be seen as different or outliers on the world stage, but the realisation that most other developed countries outlawed DTCA decades ago is not comforting. The United States is the other outlier, where several years ago it was estimated that the billions of dollars spent on DTCA there was more than 10 times greater than the Food and Drug Administration's (FDA) budget to evaluate new drugs. Here, spending on such advertising is likely to be in the tens of millions of dollars annually.
Presumably, the drug marketers consider the advertisements suggesting you ''ask your doctor if [medicine brand name] is right for you'' are value for money, but the value to health service consumers is questionable.
Those opposing the practice say the advertising can contain unbalanced or emotive information; can be misleading, downplaying or ignoring what can be lethal risks; can make patients anxious they may not be getting the right treatment and encourages consumers to pressure their doctors for the medicines which might not be clinically required or the best option.
As Ben Goldacre points out in Bad Pharma, drugs are advertised more when the number of potential patients, rather than current patients, is large. He says this can turn people into patients when they are not actually sick. New drugs get advertised more often.
These medicines have often been shown only to be better than nothing, not necessarily better than existing treatments and, even if they are as good as what is already available, they will cost more.
Those supporting DTCA consider it can increase consumer awareness of drug treatments and medical conditions and promote valuable discussion of treatment options with doctors.
Back in 2003, a group led by general practice professors reviewed DTCA 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. Such a service would provide information on the comparative risks and benefits of the drug and non-drug treatments for a condition.
This was followed three years later with a Ministry of Health consultation on DTCA, supposedly to inform future policy, which showed 69% of submissions were concerned about or opposed to the practice. Nothing changed.
Now, the issue has surfaced again in the consultation on the draft of the Therapeutic Products Bill being developed to replace the Medicines Act.
Submissions closed in April. No summary of them has yet emerged, but those supporting a ban include the Council of Medical Colleges of New Zealand, the New Zealand Medical Association, The Royal New Zealand College of General Practitioners, the New Zealand Nurses Association and a variety of health consumer groups.
The call for change has been reinforced by results of a recent Consumer New Zealand poll of 1001 people which found 57% wanted DTCA banned, opting instead for a health information service providing independent information about treatment options.
As long-time campaigner for a ban, University of Otago professor of general practice Les Toop says, ''decisions on medication that can influence long-term future health for better or for worse should be based on an understanding of evidence, realistic expectations and advice tempered with experience, not advertising spin''.
It is time for a ''transformational'' government to properly listen to these long-held concerns and have the gumption to act on them. If the pharmaceutical companies find it a bitter pill to swallow, so be it.