Prescription Drug Advertising: Same Debate, Different Day

"Moves to allow drug manufacturers to advertise directly to particular groups of patients have been rejected by European Union health ministers." This announcement may sound a little premature, given that the European Commission has just proposed relaxing the current ban on direct advertising of prescription drugs, but it's actually a blast from the past - from 2003, in fact, when ministers threw out a proposal to ease the rules after two years of discussion.

Last time, consumer groups argued that it was not the role of drug companies to provide information to patients. The umbrella group of European consumer organisations, Bureau Européen des Unions de Consommateurs (BEUC), welcomed the ministers' refusal to see informed choice for patients be reduced to "just more brand awareness." They said national authorities and the London-based European Medicines Evaluation Agency (EMEA) should be the messengers about medicines, using data from independent sources. The European parliament took a similar view. As MEP Linda McAvan, who has since been elected a vice president of the Party of European Socialists, put it: "Doctors are more trusted than companies."

So what are the chances of success for the Commission's latest attempt to prise open the gates that separate prescription drug makers from their customers?

Not much better, on the face of it. Health Action International (HAI), a respected and influential European activist group, is claiming that "advertising or promotion of prescription medicines stimulates widespread use of new medicines before their potential for harm is fully understood." The only real rationale for a change in the law, it says, is "the commercial benefit of expanding the marketing reach for pharmaceutical companies operating in Europe." It predicts that industry will be making efforts to inflate sales through emotive branding, images and messages, and warns that the measure will allow prescription-only medicines to become "just another branded commodity." The decision to advertise a medicine will always be based on its marketability and expected returns, not on its public health benefits, claims HAI.

The British consumer advocacy group Which! sees a risk that "better information" could become nothing other than advertising, and predicts that people will adopt the US pattern of demanding specific branded drugs from the doctor when cheaper, equally effective drugs are available. And a coalition of campaigners has written to Androulla Vassiliou, the European commissioner for health, urging continued tight restrictions on drug companies. "The pharmaceutical industry cannot be considered a reliable source of unbiased information, due to an obvious and unavoidable conflict of interest," they argue.

The outcome of this new version of an old debate will not be decided uniquely by health activists and consumer groups, but the vociferous reaction the proposals have provoked gives an early indication of the tone of the upcoming discussions. If the European drug industry wants to see wider options emerge for providing information to patients, it is going to have another long and tough tussle on its hands to persuade EU legislators to back the Commission's proposals. Otherwise, history might repeat itself.