“Selling sickness” means that the line between healthy and sick becomes blurred – and demand for medical treatment increases. If you’re a drug company, it’s a swell way to get consumers to demand treatment that may or may not even be necessary. So says a Dutch study that investigated industry-funded information campaigns around common conditions like restless legs syndrome, overactive bladder and heartburn.
These “ask your doctor” campaigns focused on symptom advertising or disease mongering.
Dutch law, as in Canada (but not, significantly, in only two countries: the U.S. and New Zealand) prohibits “Direct To Consumer” public advertising of prescription drugs. You might well wonder why these two countries are the only ones on earth who still permit this marketing practice.
But merely informing the public about medical conditions and health is still apparently permitted in most countries. As long as there are no direct or indirect references to a specific drug, for example, current legislation and regulation in the Netherlands regard these campaigns as “informative”. But the Dutch researchers warn that:
“Any form of influence with the apparent purpose of promoting the prescription, supply or use of a medicine or instigation of the same constitutes advertising.”
This kind of DTC promotion means that consumers are motivated to visit their physicians, either through the direct “ask your doctor” message or through a self-test. Some physicians, however, are concerned that we’re being educated by drug companies attempting to convince us that a common health condition is actually a disease that – of course – needs their expensive brand name pharmaceuticals to treat.
Consider the newly minted “disease” called restless legs syndrome. This condition actually exists, for about 2-3% of the adult population. Its most common symptoms include painful sensations in the legs, especially when sitting or lying down. According to the National Institutes of Health, there are simple lifestyle changes and activities that reduce symptoms in most people diagnosed with restless legs syndrome. These include:
- decreased use of caffeine, alcohol, and tobacco
- supplements to correct deficiencies in iron, folate, and magnesium
- changing or maintaining a regular sleep pattern
- a program of moderate exercise
- massaging the legs
- taking a hot bath
- using a heating pad or ice pack
Big Pharma, however, wants us to believe that restless legs syndrome is not just a common condition of aging that will often respond well to these simple non-drug therapies, but an actual disease that desperately needs a drug to “cure” it. Drugs called dopaminergic agents (largely used to treat Parkinson’s disease) have indeed been shown to reduce symptoms of restless legs when they are taken at bedtime, and are considered the initial treatment of choice. But although dopamine-related medications are effective in short-term management of restless legs symptoms, longterm use can lead to worsening of the symptoms for many individuals.
This doesn’t stop Big Pharma from wanting to convince us to keep taking their drugs for this “disease”.
So here’s what we already know about this type of drug ad campaign:
- DTC public information campaigns are effective
- they prompt more people to go to their family physician
- physicians then more often prescribe medicines for the condition
That is the target of the campaign. But according to the insiders at Healthy Skepticism, these tactics lead to overburdened doctors and can have a negative impact on the rational use of medicines.
Healthy Skepticism explains that, even long before a medicine becomes available on the market, Big Pharma’s pre-marketing activities begin as part of a drug company’s disease awareness campaigns.
These disease awareness campaigns involve many parties, are often designed in cooperation with a marketing agency, and typically include:
- a news release to the media about the introduction of a new drug, possibly in combination with research results that show the severity of the disease burden
- the news release is then picked up by media, who often interview the medical specialists featured in the news release
- the marketing agency supports the press release with websites about the ailment, television and radio commercials, newspaper ads and paid editorial content in magazines or on television programs
- pharmacies and doctors’ offices offer brochures, directing consumers to the product website
The Dutch research project, Gezonde Scepsis, is an initiative of the Dutch Institute for Rational Use of Medicine, supported by the Netherlands Health Care Inspectorate and the national Ministry of Health. Researchers concluded:
“Our research shows that the pharmaceutical industry makes use of the leeway offered by current definitions of the term ‘information’ to market their medicines through symptom advertising.
“Pharmaceutical companies carry out campaigns to draw consumers’ attention to diseases or conditions for which a drug solution is available. These campaigns have a demonstrable effect on increased use of these drugs.”
All good news for Big Pharma marketing, wouldn’t you say?
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