DTC Ads: Coming to a Europe Near You?

The BMJ (formerly British Medical Journal) has been tracking in its news columns the efforts of the pharmaceutical industry and some of its supporters within the European Union to bring direct-to-consumer drug advertising to Europe. Currently only the U.S. and New Zealand allow such advertising, and I understand that New Zealand is seriously considering a ban.

In 2002, the European enterprise and health commissioners proposed to the EU parliament an expansion of the allowable health information that can be disseminated to the public from the industry. The parliament overwhelmingly rejected the proposal. The commissioners made no bones about their disappointment and apparently bided their time until they could reintroduce similar proposals. Some commentators believe that they chose this spring for two reasons--first, that only 25% of the current membership of the parliament is left from the previous vote in 2002; and second, that the members of parliament are about to stand for election and so appearing to be "pro-health" will stand them in good stead. By contrast, consumers organizations in Europe are lining up in opposition.

It is a sad commentary on the state of advertising in the U.S. that the rallying cry behind this effort to loosen the limitations in Europe is a solemn promise that the end result would not be the anything-goes frenzy now characterizing the American airwaves. The commissioners insist that all they want is more readily available health information for the consumer/patient. Their critics point out that this is basically a stealth campaign, as nowhere in the proposals are there any regulations that have sufficient teeth to prevent blatantly commercial messages from going out.

For their part, the enterprise commissioners make no secret of the reason that they support loosening the rules. They believe that the pharmaceutical industry in Europe is falling behind their U.S. and Japanese counterparts in profits, and they want their part of the world to be more competitive. It is hard to see why they believe that allowing more information on pharmaceuticals to reach the public will improve the competitiveness of the local industry, unless they envision messages that will have increased drug sales as a direct consequence.

Incidentally, you might wonder, if the U.S. and Japan are held up as the "ideally" profitable drug industry nations, but only the U.S. allows DTC advertising, then how does Japan come in? I understand through one report that Japan has some interesting loopholes that allow advertising practices that in some instances nearly mimic the U.S. For example, you cannot directly advertise prescription drugs in Japan, but if you are conducting a research trial, you are allowed to advertise for volunteers. Drug companies sponsoring studies of their products put out full page ads in popular newspapers and magazines that purport to be a call for research subjects, but where about 9/10 of the advertising copy actually extols the virtues of the drug.

In April, the commissioners reported their proposals for more liberal advertising policies, and the consumers' organizations bellowed back. It was not clear from the reports when a final vote can be expected.

Brown H. Sweetening the pill. Can big pharma be trusted to provide independent health information to patients? BMJ 334:664-6, 31 March 2007.

Moynihan R. Direct to consumer advertising should not come to Europe. BMJ 334:1025, 19 May 2007.