sexta-feira, maio 05, 2006

Bitter Pill Awards

BMJ 2006;332:1050 (6 May), doi:10.1136/bmj.332.7549.1050-a

Watchdog gives spoof awards for aggressive marketing of drugs

London Owen Dyer

The lobbying group of the US drug industry, Pharmaceutical Research and Manufacturers of America (PhRMA), last week won two spoof awards from a watchdog that tracks aggressive and misleading marketing by the industry.

PhRMA led the field in the second annual Bitter Pill awards, winning prizes in two categories from the Prescription Access Litigation Project, a national umbrella organisation of 118 consumer health advocacy groups.Aggressive marketing is driving up health costs and encouraging patients to take drugs they do not need, argued Jerry Avorn, a professor at Harvard Medical School and one of the organisers of the awards. "As a physician I have seen how the avalanche of direct to consumer drug advertising infects the doctor-patient relationship," he said.

The first of the two awards was for the organisation's guidelines on direct to consumer advertising, which the consumer pressure group claimed were ineffective, not least because they had no enforcement mechanism. It was called the "Fox Guarding the Hen House" award.

PhRMA received even less flattering recognition with the "Truth is Stranger than Fiction" award, for "commissioning a hackneyed thriller to scare Americans about Canadian drugs."

In an effort to discourage drug purchasing across the border the PhRMA consultant Mark Barondess last year persuaded the industry group to spend $100 000 (£54 600; EURO79 300) underwriting a thriller in which Islamic terrorists put poison in Canadian generic drugs to kill American consumers (BMJ 2005;331:1103). After seeing the manuscript Mr Barondess tried to cancel the project, but the authors went ahead with publication despite legal threats.
The Karasik Conspiracy was published in December but with a new plot wrinkle: in addition to the terrorists, a fictional US drug company plans its own attack to scare consumers away from Canadian drugs.

The Bitter Pill "counter awards" were timed to coincide with the industry's own national awards for the most effective direct to consumer drug advertisements.Direct to consumer campaigns featured in three of this year's Bitter Pill awards, with the dubious honours shared among five of the country's best selling drugs.

The "Got Cholesterol?" award, given for "overpromoting expensive brand name statins," was presented to Pfizer's atorvastatin (Lipitor) and AstraZeneca's rosuvastatin (Crestor).
Rosuvastatin was the subject of a Food and Drug Administration enforcement letter last year, over a television advertisement claiming that the drug was more effective than other statins.

The Driven to Distraction Award, "for hawking an attention deficit drug by distracting consumers with ADHD [attention-deficit/hyperactivity disorder]," went to Eli Lilly, for a televised advertisement for its drug atomoxotine (Strattera). This advertisement showed daily life as a video game, in which a person lost points for being distracted or disorganised. Messages describing these penalties flashed on the screen as the drug's side effects were being shown.

In a letter of complaint the FDA charged that the graphics worked to "undermine the consumer's ability to pay attention to and comprehend risk information." But by the time the letter was issued the campaign was over. Last September the atomoxotine campaign was a winner at the Pharmaceutical Advertising and Marketing Awards.

The "While You were Sleeping" award, given for "overmarketing insomnia medications to anyone who's ever had a bad night's sleep," was shared between zolpidem (Ambien and Ambien CR, made by Sanofi-Aventis), and eszopiclone (Lunesta, made by Sepracor).

The Bitter Pill organisers described Ambien CR as a successor drug, designed primarily to stave off generic competition when the original Ambien's patent expires in 2007. Eszopiclone's advertising campaign cost Sepracor $215m last year-more than the company's average quarterly revenue. Sepracor is now reporting net profits for the first time, largely on the strength of sales of eszopiclone.

None of the drug companies named in the awards had returned calls from the BMJ requesting comments as the journal went to press.

But PhRMA last month set up a new panel to "review trends in direct to consumer (DTC) advertising as they relate to PhRMA's voluntary Guiding Principles." Professor Lawrence Brown of the University of Tennessee, who chairs the new panel, said: "DTC advertising can play a valuable role in educating patients and health care providers about health issues and options. However, over the years, there have been concerns that DTC may oversell benefits and undersell risks or lead to inappropriate prescribing practices." He said he hoped the new panel would "help DTC advertising and the PhRMA Guiding Principles live up to their potential."

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