Call for Advertising Ban in Prescribing Software
Pharmaceutical promotion that appears in prescribing software should be banned because it leads to expensive prescribing habits and unrealistic consumer expectation say the authors of research published in the current issue of the Medical Journal of Australia.
Dr Ken Harvey, Senior Lecturer at the School of Public Health, La Trobe University in Victoria, and colleagues, say they are concerned that an industry that spends two to three times as much money on marketing as on research and development distorts the information flow to health professionals and consumers.
The authors say pharmaceutical promotion has been shown to influence doctors' prescribing and leads to PBS cost blowouts due to the prescribing of more expensive drugs.
The call to ban pharmaceutical advertising in prescribing software follows analysis by the authors of advertisements displayed by Medical Director version 2.81 (Health Communication Network, Sydney, NSW) in early 2005.
The researchers looked at the placement, frequency and type of advertisements, and their compliance with Medicines Australia Code of Conduct, which sets ethical standards for pharmaceutical companies to adhere to when promoting prescription medications.
They found that 24 clinical functions in Medical Director contained advertisements. These included 79 different advertisements for 41 prescription products marketed by 17 companies, including one generic manufacturer. Ninety five percent (57 out of 60) of the advertisements making a promotional claim appeared noncompliant with one or more requirements of the Code. "Common problems included missing information, illegible generic names, and claims that were unsubstantiated or appeared not to be in accord with the published literature," say the authors.
The authors also analysed a debate on this topic held on the General Practice Computer Group email forum (GPCG_talk) during December 2004. Twenty nine contributors, primarily GPs, posted 174 emails to GPCG_talk. There was little support for these advertisements, but some concern that the price of software would increase if they were removed.
The authors were also concerned that patients might be exposed to prescription pharmaceutical advertising via the computer screen while discussing medication with their doctor. "Given the potential public health consequences of promoting prescription pharmaceuticals through software shared with patients, we argue that pharmaceutical promotion should be eliminated from prescribing software," they say.
Also in the same issue of the Journal, Tilman Ruff, Associate Professor in the Nossal Institute for Global Health at the University of Melbourne, and Hadia Haikal-Mukhtar, Melbourne GP, agreed that such advertising was an inappropriate intrusion in the patient-doctor interaction. They say the disproportionate amount of money spent on advertising is an issue for the pharmaceutical industry, doctors and the rest of the community in terms of distorted priorities and large opportunity costs
Dr Ruff said all codes of conduct and other professional standards require regular review and updating, and enforcement of the Code of Conduct for the pharmaceutical industry needed to be strengthened. His other recommendations include the possibility of capping advertising expenditures across the industry, as occurs in the United Kingdom; and appropriate professional interactions with industry and standards for these should be part of undergraduate and postgraduate medical training and education.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Dr Ken HARVEY 0419 181 910 / 03 9479 5773(w) / 03 9818 1910(h)
Associate Professor Tilman RUFF 0438 099 231
Judith TOKLEY, AMA Public Affairs 0408 824 306 / 02 6270 5471