This article was originally published in 1992. We’re printing it today in 2005 because essentially nothing was done to improve the situation, and, according to Dr. Marcia Angell, whose book, The Truth About the Drug Companies, is reviewed on page 13, claims that the situation has gotten even worse.
One hundred and fifty academic physicians and pharmacists, reviewing 109 drug company advertisements in 10 prestigious medical journals in early 1990, have come to the startling conclusions that almost half the ads contained dangerously misleading information.
What a shock!
The Pharmaceutical Manufacturers Association (PMA), the trade group representing the drug manufacturers, has attacked the study, which it says maligns the entire industry.
Of course, the PMA also claims that physicians don’t base prescribing decisions on the $351,000,000 in advertising its members place in medical journals.
Right. Bristol Laboratories placed a 12-page that’s right, 12 full pages ad for its antibiotic Cefzil in the March 15, 1992 Annals of Internal Medicine as a public service.
And what an ad it is. A relatively low-key opening page announcing the “new oral antibiotic,” followed by a full page photo of a man whose bronchial tract is superimposed in reflective silver on the photo. Two pages later, a full-page photo of an oh-so-cute toddler features a silver throat and sinuses, followed by an older man with silver bronchial tract.
The same issue of the Annals the journal, by the way, that just published the study of advertising features a 10-page ad for a new drug for reducing cholesterol levels. This package features a cut-out through four of the pages, that shows a lift-off seal on the fifth page. Get to page five, pull off the seal and find nothing underneath.
I don’t for a minute claim to be able to analyze the technical accuracy of these ads, but I can certainly attest to the salesmanship and innovative design they include. That and the fact that someone obviously has a great deal of faith in their ability to sell drugs.
These advertisements for lifesaving and life-extending medications, whose use often entails life threatening risks, are on a par with the slick ads you see for sneakers and cars. And we know how honest those sales pitches are.
The fact that some 44 percent of the ads studied contained misleading information is bad enough. But an even more disturbing fact emerges from the designing of the study.
Because they didn’t want even the appearance of a conflict of interest, the researchers decided that they would exclude from the panel of physicians reviewing ads anyone who had received more than $300 from pharmaceutical companies in the previous two years.
It turned out, however, that 71 percent of the reviewers fell into the category, and 53 percent had received more than $5,000 from drug companies.
Needless to say, the researchers dropped their requirement that the advertisement reviewers not have received pharmaceutical money.
Which means, of course, that more than half of the doctors judging the accuracy of the drug ads had received an amount of money 16.6 times greater than what the researchers felt would create at least an appearance of conflict of interest.
So what are we left with? A study by a group of drug company-funded physicians and pharmacists that says that drug company ads are misleading.
Which tells you both how pervasive the influence of these companies are and how outrageously misleading their ads must be.
Clearly, it is time for the FDA, which virtually never reviews drug company advertising prior to its publication, to start reviewing advertising in much the same way it monitors informational inserts in packages.
At the same time, it is also clear that something needs to be done to reduce the cash flow from drug companies to physicians. It is one thing to pay the costs incurred by a physician participating in a study; it is another thing entirely to pay literally thousands of physicians to appear at medical meetings and news conferences to shill for the drug companies.
Under the present system, you can’t help but wonder whether your physician is prescribing a particular drug because it’s the drug you need, or because the ad for the drug caught his eye. Or, even worse, is the physician prescribing the drug because its manufacturer sent him and his wife to Hilton Head for four days in exchange for the doctor giving a 30 minute talk while he was there?
Reprinted from Green Merchant