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| Protecting the pharmaceutical industry's image has become a top priority |
| Addressing Concerns about Pharmaceutical Marketing Promotion: a US and EU Perspective |
It's old news. The pharmaceutical industry is now the demon everyone loves to hate - on both sides of the Atlantic. The industry has come under fire from the media, consumers, the professional community and government agencies. Why? Critics claim that "unethical promotion" proves the industry cares more for profits than patients and has created a climate of distrust around the safety and efficacy of our medicines.
This controversy erupted recently into a very public battle over "unsafe COX-2s" and "over-prescribed antidepressants". The ensuing negative environment stirred a wake-up call that protecting the industry's image has become top priority. Clearly, the industry is beginning to take steps to reinforce the value of medical products in the minds of its stakeholders. But for this outreach to make a real impact, it has to be sustained and strongly supported by individual companies.
US Perspective
In the US, drug promotion regulation ensures free exchange of information. Drug industry communications have long empowered consumers with the knowledge they need to make informed healthcare decisions. In 1997, when the Food and Drug Adminstration (FDA) set new rules for direct to consumer (DTC), it allowed the industry to more openly promote advances in therapy and encourage consumers to discuss them with their health professionals.
Direct to consumer, however, has become a moving target for critics who want lawmakers to curtail the ads, claiming they are deceptive and could contribute to higher drug prices. They miss the point. Consumers need information to become active members of the healthcare team. The industry, however, has to help consumers vet and understand that information and temper its advertising with a recognition that pharmaceutical companies care about the health and safety of its patient populations.
It is worrisome that advertising has helped convince people that all drugs are completely risk-free. Drugs do save lives and dramatically improve life-styles. They are crucial weapons in the battle against illness, but anything that powerful may also have side effects - some benign, others not.
 | Clearly, the industry is beginning to take steps to reinforce the value of medical products in the minds of its stakeholders. |  |
The FDA was right, therefore, to keep the COX-2s on the market to treat arthritic pain, as well as to recognise that antidepressants have revolutionised the treatment of mental illness, neutralising its stigma in society. The key here is an understanding of each drug's risk/benefit ratio and the pharmaceutical industry could raise its positive profile by enabling these discussions. More focused DTC could be the first step.
Indeed, many industry executives are beginning to re-evaluate use of DTC amid concern that messages are damaging the sector's already poor image. Advertising seems to have levelled the playing field, equating medicines in the consumer's mind with cars, electronic equipment and soft drinks. Medicines, however, are not frivolous products and the tone of drug ads has to convey that drugs are, indeed, serious.
The answer is not to ban advertising, but to bring it back into balance. Raising awareness about disease and possible therapies can improve public health. But we've gone "from this drug is right for everyone" to "this drug is wrong for everyone". Instead, we should settle on: This drug is critical to the health of these specific patients.
Similarly, the answer is not to demonise the industry. Rather, the industry has to do a better job of explaining the value of pharmaceutical products. Unbranded patient education that advances knowledge about disease states and public health issues is important to the wellbeing of people everywhere.
The industry should remember that the genesis of drug promotion was education. Companies have to see patients as whole people, bond with them, and help them communicate with their healthcare professionals more effectively.
EU Perspective
Here the industry is highly regulated. Payors drive the process. There is no DTC in Europe, at least not yet anyway. DTC has been considered for chronic conditions in the EU, but in light of the recent US experience, this seems less likely now. We have no "brand promotion" but as a result, there is a dearth of helpful communication to the patients, often forcing them to make decisions in a knowledge vacuum or worse still, from unreliable sources on the Internet.
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| Experts agree that patients need more information to improve their health outcomes, not less. |
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Throughout Europe the negative environment is caused by a perceived abuse of medical education and selective publication of clinical trial results. Did that expert write that article or did the pharmaceutical industry ghostwrite it; have the pharma industry been open with all the data? This sense of uncertainty has put the credibility of expert opinion in question, and the loser is the consumer.
The COX-2 and antidepressant issues have had their effect here too, occurring at such a sensitive time for the industry, when current perceptions of lack of transparency are high. The MHRA (the UK regulatory body) is clamping down on unethical advertising to the professional community. The Health Select Committee is looking at pharmaceutical marketing practices and how ethical they are. The British Pharmaceutical Industry Association claims it has no desire to see US-style consumer advertising for medicines in the UK.
But no one is saying consumers don't need information. In fact, experts agree patients need more information to improve their health outcomes, not less. Both the Chief Executive of the MHRA and head of the European Medicines Agency, the pan European regulator, encourage the communication of information to consumers on innovative drugs.
The industry can be proud of its on-going efforts to educate payors, physicians and patients in support of concordance and compliance and prescription information. More important, companies are continuing to explore new ways of communicating with patients, through already available channels. Most significant are consumer package inserts (PILs), which offer disease education, better risk/benefit discussions and suggested lifestyle changes.
We all understand that physicians diagnose and prescribe. Educated consumers, however, learn they have to see a doctor to take care of the problem - and to comply with the diagnosed regimen. It is likely we will see an increase in Direct to Patient communications to support this.
Speaking as One Voice
The bottom line is that everyone will benefit from:
- Responsible marketing, in which science leads the way to highlight a product's benefits as well as the risks.
- Greater transparency on safety and conflict of interest issues to rebuild public trust.
- Direct to Consumer education resulting in savvier patients and healthier people.
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Laura Schoen, president, global healthcare practice, Weber Shandwick and Fiona Hall, UK healthcare practice managing director, and European practice chair.
Reproduced with the kind permission of Pharmaceutical Marketing Europe and Communiqué in the US.
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