"What we've suggested is allowing an appropriate amount of time for doctors and other health professionals to be educated about the medication," says PhRMA's Ken Johnson. "This will vary from product to product—a breakthrough cancer drug would take longer than an athlete's foot cream, for example."

Pfizer, however, has decided to put a minimum time period on all products slotted for promotion. "Pfizer has committed to educating physicians for a minimum of six months before beginning TV and print product-branded advertising to consumers," says Jim Maffezzoli, team leader for Pfizer's consumer strategy team. "[This] applies to newly approved products where doctors have expressed a desire to have time to become more familiar with the medicine."

Broadcast advertising

"Pfizer will no longer create 'Go ask your doctor about a medicine' TV and print advertisements that do not include the benefits and risks associated with the advertised medicine," a company statement said. Pfizer will, however, air "dedicated, nationwide TV and print advertising promoting Pfizer Helpful Answers, assistance programs which may help under insured people to pay for medications.

Television and print

TV and print ads should be designed to achieve a balanced presentation of a drug's benefits and risks. Specifically, risks and safety information should be clear, understandable, and presented in a manner supportive of dialogue between patients and physicians, according to PhRMAs Principles. Pfizer says it has already made changes to meet these goals.

"The new consumer-friendly brief summary currently appearing in Lipitor [atorvastatin] print advertising is designed to more effectively communicate risk and benefit information in an accessible way," Maffezzoli says. "And to support the doctor-patient dialogue, we are implementing improvements, such as including alternative treatment language in our advertising. For example, the new campaign for Zyrtec [cetirizine] includes an example of what the doctor may suggest, such as ways to first remove or avoid allergens using a dehumidifier, as well as medication options like Zyrtec."

Other changes afoot at Pfizer in 2006, according to a company statement, include a vow to "invest a meaningful amount—on par with what it spends on a branded advertisement campaign" to create more unbranded disease awareness ads (such as the "Why Live With Depression" ad starring Sopranos actress Lorraine Bracco). The company also plans to take a closer look at ad placement "to avoid audiences that are not age appropriate." In particular, the company says ads for erectile dysfunction drugs like Viagra (sildenafil citrate) will be aired during programs with a primarily adult viewership.

"Our hope," Maffezzoli says, "is that these changes will result in making consumer advertising more effective at encouraging more valuable patient-healthcare professional dialog, helping consumers better understand the risks and benefits of prescription medicines, and motivating people to overcome significant barriers to better health."