The CMA has made it official: it staunchly opposes the use of direct-to-consumer (DTC) advertising of prescription drugs in Canada.
There are restrictions on DTC advertising of drugs in Canada, but not in the US, where the DTC approach has had a huge impact (CMAJ 2002;167[3]:289). There, sales of the 50 drugs with the biggest DTC advertising budgets accounted for 48% of the US$20.8-billion increase in retail spending on prescription drugs from 1999 to 2000. Improved sales of the remaining 9850 drugs accounted for the rest. In 2000, Merck spent the same amount (US$161 million) on DTC advertising for one drug, rofecoxib (Vioxx), as Dell spent advertising its computers.
In a position statement approved in September, the CMA says it wants Canada to maintain its stricter rules because DTC advertising makes viewers think of prescription drugs as consumer goods, not as chemical products that deliver specific health benefits. “What we are really opposed to is the no-holds-barred American-style advertising,” says Dr. Claude Renaud, the CMA's chief medical officer.
The position statement says DTC advertising “may not provide enough information to allow consumers to make appropriate drug choices” because it ignores information about competing products. As well, the ads may drive up the cost of care and strain the patient–physician relationship if a request for an advertised drug is refused.
Renaud says the new statement makes official a position the CMA had already taken in letters to federal ministers of health. The position statement says DTC advertising is used because of its mass-marketing potential, not to inform consumers. The statement was approved in September because Ottawa may start reviewing the issue this fall. There is also concern that the current federal industry minister — former Health Minister Allan Rock — has not formally opposed DTC advertising. “That worries us,” says Renaud. — Patrick Sullivan, CMAJ