OPINION: News Analysis - No longer in the realm of the purely medicinal/The pharmaceutical industry is readying itself for a major overhaul of the way drugs are marketed if US-style consumer advertising is introduced in the UK

Last month, Hill and Knowlton merged its ethical and consumer healthcare divisions to create a single offering, reflecting the increasingly consumer-driven focus of the drugs market.

Last month, Hill and Knowlton merged its ethical and consumer

healthcare divisions to create a single offering, reflecting the

increasingly consumer-driven focus of the drugs market.

As UK law stands today, it is illegal to market, advertise or promote

prescription only medicines (POMs) to the general public. This is backed

by the Association of the British Pharmaceutical Industry (ABPI), which

has a self-policed, but rigorously enforced, code of practice.

The ban aims to protect the interests of patients and ensure that GPs

have a free hand to offer the most appropriate medical advice. However,

last year the US began allowing controlled DTC (direct to consumer)

advertising for pharmaceutical products and many would like to see the

European market go the same way.

’We have many drivers for change, mostly from patients who want to know

more about their medicines and their healthcare in general,’ says ABPI

head of media Richard Ley. In the UK, this is reflected in the growth of

media doctors and a decline in public confidence in GPs.

But change is also being driven by the current contradictions in

accessing drug product information. For example, a search on the

internet for the latest date about anti-impotence drug Viagra, throws up

a confusing wealth of web sites - some good, some utter junk. It would

seem a safe bet that Viagra manufacturer Pfizer would offer the one web

site where such information would be ethically presented. But legally,

Pfizer’s hands are tied over how much data it can present in a public


While the majority of players in the debate on the future of POMs

promotion agree that the current situation in Europe will have to

change, some have reservations about the long-term implications. Dr

James Kennedy, prescribing spokesman for the Royal College of General

Practitioners, says:. ’What concerns us about DTC advertising is that it

is potentially confusing if information is incomplete or data biased

towards one product.’

In addition, GPs could face patients demanding medicines they have seen

advertised, which are inappropriate to their specific condition.

But a far wider concern is the prospect of market forces governing

public health. Take diabetes for example, which currently goes

undiagnosed in a significant number of the UK population.

Under current legislation, if a pharmaceutical company is looking to

promote its diabetes product, a disease awareness campaign would be a

sensible option. With DTC advertising, a more cost-effective option may

be a product-driven campaign, limited to diabetes sufferers only.

However, it seems inevitable that legislation, which is governed by

Europe, will change and estimates on the timing range from two to five


Drugs companies are already actively marketing to consumers. With

products such as Benecol and Yakult on the market that offer health

benefits backed by clinical trials, there is a steady blurring of the

lines between what is a pharmaceutical company and what is not.

’Traditionally, the main audiences for POMs has been healthcare

professionals and the purchasers within the Department of Health, with

the end users stuck in a grey box,’ says Dr Martin Godfrey, head of

H&K’s European health and pharmaceutical practice. ’Combining ethical

skills with FMCG expertise and techniques for building brands will bring

huge benefits to the pharmaceutical industry,’ he adds.

Indeed, in PR terms DTC has been around for years, with opinion leaders

staying within the rules, but effectively promoting drugs within the


For example, although Pfizer could not promote Viagra to consumers, it

hired Ruder Finn Worldwide to ensure journalists had a reliable source

of information on the drug.

Dr Godfrey believes that if a consensus could be found between the

health professionals, the Department of Health and the pharmaceutical

industry, DTC advertising would bring benefits to all. ’But advertising

should be purely for giving information, it must not undermine the

doctor-patient relationship,’ he warns.

However, no matter how much the pharmaceutical industry itself talks

about legislative changes bringing greater freedom of information, it is

hard to ignore that its bottom line is profit.

Could advertising prescription drugs directly to consumers mean less

business for PR agencies? Cohn and Wolfe executive healthcare director

Angie Searle thinks not.

’DTC will never happen in isolation,’ she says. ’Clients will still need

an integrated marketing approach. It depends how far legislation goes,

but DTC advertising can only ever say so much, because it has to feature

contra-indications and side effects. So PR will be needed even more to

put the facts into context and drive home the product benefits and

differentials by using third parties to get the endorsement you can’t

get from an ad.’

As the Government struggles to foot the bill for the NHS, many predict

that a strong Labour showing at the next general election will usher in

a new era of co-payment for prescription drugs. If people are forced to

make a greater financial contribution, then they will want to know that

they are receiving the best possible medicines.

In such a scenario, it seems inevitable that advertising to consumers,

where it is backed by high quality media campaigns, would be in

everyone’s best interests.

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