[A-List] Unhealthy accumulation: hallucinatory advertising

["Michael Keaney" <michael.keaney@xxxxxx>]

Half of all adverts for drugs are 'misleading'

Doctors advised not to rely on claims for new treatments
By Sarah-Kate Templeton, Health Editor
The Sunday Herald, 12 January 2003

Almost half the claims pharma ceutical companies make about their drugs in
advertisements in medical journals are inaccurate and misleading, new
research has found.

Colourful drug adverts in medical journals now include professional-looking
references to back up claims. But researchers found that 44% of the 102
claims analysed were not supported by the references quoted at the bottom of
the adverts.

Doctors investigated promotional claims in six medical journals about drugs
that lower blood pressure and cholesterol. The researchers looked at claims
of efficacy, safety, convenience and cost.

The study, published in the Lancet medical journal, concluded: 'Doctors
should be cautious in the assessment of advertisements that claim a drug has
greater efficacy, safety, or convenience, even though these claims seem to
be supported by bibliographical references to randomised clinical trials
published in reputable medical journals and seem to be evidence-based.'

The most common complaint was that the studies quoted referred to a
different group of people than those targeted by the adverts.

'When the bibliographical reference did not support the advertising claim,
the most common reasons were very misleading: results from studies done in
patients with specific characteristics had been automatically transferred to
the population at large; alternatively results were applied to specific
categories of patients, for example, diabetic patients, elderly people or
women when these patients had in fact been excluded from the study.'

The paper follows a similar study, published in Annals of Internal Medicine,
carried out in 1990 when experts were asked to judge the validity of claims
made in adverts published in 10 leading medical journals. In the reviewers'
opinions, 44% of adverts would lead to improper prescribing if a physician
had no other information.

Dr Salvador Peiro, from the Valencia School for Health Studies, was lead
author of the new paper. He said the lack of improvement over the last
decade is due to weak regulation.

'The combination of a series of factors, including the large volume of
advertising material, the weakness of the inspection procedures, the complex
bureaucracy of the sanctioning mechanisms, and the imagination of the
advertisers who place claims within the very limits of truthfulness, make it
difficult to use regulations to effectively control advertising.'

The study comes just weeks after a UK advert for a new contraceptive pill,
used by thousands of women in Britain, was ordered to be withdrawn because
it was deemed misleading.

Adverts for Schering's Yasmin claimed that, unlike other contraceptives, the
new pill would avoid weight gain and give women a sense of well-being.
Schering launched the pill last year, with adverts showing an attractive,
smiling woman in soft focus alongside the strapline: 'The pill for
well-being.'

At £59 for 12 cycles of treatment, the pill costs the NHS up to eight times
more than any other combined oral contraceptive. The adverts had to be
withdrawn after the government's Medicines Control Agency (MCA) found that
the claims could not be supported.

But the MCA gave the Yasmin ad the all-clear last June. It was only
withdrawn when the government agency was forced to review its decision
following complaints from experts.

Dr Joe Collier, editor of the Drug and Therapeutic Bulletin, which first
raised concerns about the Yasmin ad, is calling for an inquiry into how the
MCA operates. He welcomed the new research and called for all ads to be
vetted before publication.

'Yasmin is a very good example of where the evidence quoted doesn't support
the claims.

'This is a very important paper. We know that billions of pounds are spent
each year on adverts so one assumes that these influence doctors. We need to
know how the MCA vets ads. The Yasmin case shows how misleading adverts can
pass through the Medicines Control Agency.

'The MCA should pre-vet all adverts. At the moment we think they are checked
randomly but we have no idea how it is done because the MCA will not tell
us.

'The MCA's slowness and secrecy are wholly unacceptable, particularly since
huge amounts of taxpayers' money may have been inappropriately spent on
Yasmin due to the exaggerated claims made by Schering.

'The MCA's position is untenable and demands an inquiry. We have never found
out what went wrong with the Yasmin ad -- why the MCA failed to notice that
it was making false claims in the first place. We need to know that they
have improved things.'

The MCA said in a statement that it routinely monitors adverts for medical
products. The agency claims it takes action 'as necessary' and last year
forced around 50 adverts to be amended or withdrawn.

The MCA added: 'The degree of regulatory scrutiny of individual
advertisements varies but we pick up a number of potential breaches of the
regulations in this way. Advertising is not submitted to the MCA for
pre-approval, nor is it required to be.'