DTC advertising battle heats up
Pfizer's Viagra blitz a sign of growing activism by pharmaceutical companies

Amidst growing cross-border spillover effects from direct to consumer advertising by U.S. pharmaceutical companies, the domestic debate about whether these ads are a boon or curse is heating up.

"The rise of the Internet and the fall of broadcast regulation have changed pharmaceutical marketing environment so much, that existing regulations are not very practical," said Jean-Michel Halfond, president of Pfizer Canada.

Under the current regime, Canadian pharmaceutical manufacturers are allowed to educate consumers about a particular medical condition, or they are allowed to promote their brands. But they cannot do both in the same ad. This complex regulatory framework is forcing companies to do back flips in order to get their message out.

For example Pfizer's latest blitz to promote its erectile dysfunction drug Viagra encompasses two ads. The first features ex-hockey legend Guy Lafleur sitting in a dressing room talking frankly about erectile dysfunction.

The second, titled "Good Morning," depicts an exuberant man dancing to a catchy tune on his way to work, the day after a presumably active evening. The only text is written onscreen at the end of the ad: "Viagra - talk to your doctor."

Although this strategy of running concurrent commercials is not new, Pfizer's campaign is particularly aggressive and visible, due to the impending arrival of two, and possibly three competitors who will be introducing their own brands of erectile dysfunction products in the near future.

Pharmaceutical manufacturers argue that their role in the medical information process is changing, in light of increasing lineups in medical clinics, doctors unable to allocate the time required to each patient, and ordinary Canadians taking increased responsibility for their wellbeing.

"We're not just educating doctors on a specific drug; we're educating Canadians about disease management and diagnosis," said Halfond. "This is a major change for us, and a highly necessary one."

But the pharmaceutical industry is not the only one arguing for relaxed direct-to-consumer advertising rules. The advertising dollars that would inevitably result also give the media a big stake in the issue.

The relaxation of Canadian rules could mean between $90 million and $120 million per year in new revenues for Canadian broadcasters and print media if we use the U.S. experience as a guide, and prorate using a twenty-to-one ratio, since Americans spend more per capita on ads than we do.

That's big money. So three years ago a group composed of various media organizations and the Institute for Canadian Advertising, began making its voice heard through an organization called The Alliance for Access to Medical Information.

Among the organization's initiatives were extensive polling of Canadians by Ipsos-Reid about their feelings regarding DTC advertising, the results of which were released earlier this year. Among the findings: 85 per cent of Canadians would be in favor allowing DTC ads, if they were prescreened for balance and accuracy by a government appointed regulatory agency, a solution favored by the AAMI.

Not surprisingly, 53 per cent of the 1503 Canadians surveyed believed that DTC ads were already legal in Canada, a clear demonstrations of the cross-border effects of U.S. ads.

But not everyone thinks that direct to consumer advertising by pharmaceutical manufacturers is such a great thing. The medical profession has been long opposed to the practice, arguing that this kind of advertising causes more problems than it solves.

And recent research by a University of British Columbia post-graduate student has given them some good ammunition. According to Barbara Mentzes, who researched the issue for her Ph.D. thesis in epidemiology, which was partially funded by Health Canada, direct to consumer advertising by pharmaceutical companies is putting pressure on physicians.

Mentzes surveyed 1,431 patients and 78 doctors, about half from Sacramento California, (where DTC ads are allowed, and the rest from Vancouver, British Columbia, (where they are highly regulated). Not surprisingly, U.S. patients were twice as likely to ask their physicians for prescription drugs by name as Canadian patients.

The problem is that doctors appeared to be pressured to prescribe the medication requested, sometimes against their better judgement. "Physicians were ambivalent about the choice of treatment in around 40 per cent of cases when patients requested drugs (advertised and non-advertised), compared with 12 per cent for drugs not requested by patients," she wrote in an article in a February article in the British Medical Journal.

"The aim of DTC advertising is to sell products that generate income. That's why there is so much of it," said Mintzes, who considers herself a consumer rights activist, in a recent interview. "But there is no evidence that direct to consumer advertising improves the overall health of the population."

However according to Pfizer's Halfond, physicians remain the gatekeepers to the health system, and maintain the right to prescribe medication as they see fit. He also notes that many erectile dysfunction patients went to see their doctors about Viagra, eventually discovered they were suffering from other ailments such as diabetes or hypertension. And this would not necessarily have come to light as quickly without the advertising.


Photo Caption: Pfizer alternated its "Good Morning" Viagra commercials which mention the product's name, but not what it does, with commercials featuring Guy Lafleur who talks about erectile dysfunction, without mentioning Viagra.


Highlight this quote: "The aim of DTC advertising is to sell products that generate income. That's why there is so much of it," said Mintzes


Diekmeyer's E-mail address is peter@peterdiekmeyer.com


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