So – just when I think I’m breaking new ground…
Charles Medawar at Social Audit has written the definitive piece on the subject – and he wrote it 2001. You can see it here at Social Audit. This really is an excellent piece which was in fact published as a briefing for Members of the European Parliament on DIRECT-TO-CONSUMER DRUG PROMOTION:
“There is clear and worrying evidence that European patient organisations are coming to resemble their counterparts in the USA. The industry has gone to great and sometimes improper lengths to get patient organisations on side – sweetening them to an extent that might be expected to diminish fairness, integrity, transparency and healthy competition.
· The National Alliance for the Mentally Ill (NAMI) – “a grassroots organisation of individuals with brain disorders and their family members” – received $11.72 million from 18 Pharma companies, between 1996 and mid-1999. NAMI’s leading donor was Eli Lilly, maker of Prozac. They gave £2.87 million during that period. (Silverstein, 1999)
· “The drug companies have also spent millions over the past decade to create seemingly independent groups that promote their agenda. Last year, the industry trade group created Citizens for Better Medicare, which has been waging a $50 million advertising campaign against a government-controlled prescription drug benefit. And lobbying records show that the drug companies are major backers of the Alliance for Better Medicare, which describes itself as ‘a coalition of nearly 30 organizations representing seniors, patients, medical researchers and innovators, doctors, hospitals, small businesses and others’.” (Gerth & Stolberg, 2000)
· “As chairman of the Danish Migraine Association, I often stand up and tell the media and my fellow chairmen of other patient organisations that we have to be extremely careful in order not to be in effect advertising organs for the medical industry. When the Danish Migraine Association refused to take industry ‘assistance’ to write and print the magazine, organise the lectures and generally run the association, the industry, generously assisted by the research doctors, literally created a new patient organisation as a substitute for the Migraine Association in 1996. This was a bit too blatant to be generally accepted among informed patients and opinion makers, but only because we did not accept the situation gracefully, and made the press aware of our situation. I still hear about patient organisations that are literally being taken over, and who do not even understand what goes on. Luckily we have a growing awareness about the problem.” (Bulow-Olsen, 2000)
· “A pharmaceutical company will tomorrow break new ground by encouraging the public to demand that the NHS pay to make available one of its drugs. The campaign, Action for Access, is funded by Biogen and organised by a PR company on its behalf. It will urge multiple sclerosis sufferers to demand their health authorities agree to prescribe beta-interferon on the NHS, a very expensive drug, which can help some sufferers, but not all.” (Boseley, 1999)
· In 1999, the UK-based Patients Association joined forces with Pharmacia and Upjohn (P&U) in a prototype DTC television campaign aimed at “raising awareness” about urinary incontinence. The TV commercials mentioned no brand name, but encouraged patients to see their doctor. Those who did stood a good chance of being prescribed the leading and most heavily promoted brand, Detrusitol (tolterodine, P&U). However, tolterodine is relatively ineffective. It would probably not help most users much more than a placebo, and non-drug treatments would often be preferable. P&U had also repeatedly attracted criticism for misleading advertising, notably in the USA. Between 1998 and 2000, P&U received five warning letters from the US Food & Drug Administration. In the two most recent, the company was taken to task for making headline claims about the “selectively” of its product – suggesting that it acted on the bladder, with less drying-up effects in the mouth. P&U evidence was based not on clinical trials, but on studies with cats. In the UK, the company resisted regulatory pressure for over a year. The Patients Association became aware of this too late: they had already supported the TV campaign and accepted a large donation from P&U. In turn, they said a nice thank-you to the company and gave it one of their ‘Platinum Awards’.”