The educational value of industry-sponsored disease awareness advertising could be improved if regulations and guidelines stipulated disease information requirements, such as inclusion of risk-factor and symptom information.
In countries where direct-to-consumer advertising (DTCA) of prescription medicine is prohibited, pharmaceutical companies can indirectly promote medicines via disease awareness advertising (DAA). DAA typically contains information on a disease and recommends that consumers speak to a doctor for further information. Companies sponsor DAA for conditions for which they manufacture a treatment, and often run concurrent branded advertising campaigns that target general practitioners.
DAA sponsored by pharmaceutical companies may negatively influence consumers, generate unnecessary fear, and create a greater reliance on medications to solve social and behavioural problems. DAA has been identified as a form of disease mongering or “widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments”. DAA is often directed at lifestyle conditions for which there are large, lucrative markets (eg, balding or erectile dysfunction) A Dutch study found that a DAA campaign increased disease-related consultations and prescriptions for the advertiser’s product for what may be considered an unimportant health issue.
However, DAA can also provide information to help consumers identify symptoms and seek information about and treatment for previously untreated conditions. Advocates consider DAA to be particularly important for diseases that are considerably underdiagnosed (eg, diabetes).
In Australia, advertisers of therapeutic goods are bound by the Therapeutic Goods Act 1989 (Cwlth) and the Therapeutic Goods Administration (TGA) Therapeutic Goods Advertising Code, which prohibit DTCA. Although the definition and regulation of DAA is not explicit in the current Code, this form of advertising was recognised in a review of the therapeutic goods legislation. The review identified pros and cons of industry DAA, including its potential use as a method of skirting current regulations that prohibit DTCA. It called for the development of a code of practice with clear parameters for DAA, with an aim to increase the potential benefits and decrease the potential disadvantages. The formative Australia New Zealand Therapeutic Products Authority (ANZTPA), which aims to establish a trans-Tasman regulatory scheme for therapeutic products, defined DAA in its draft advertising code. The establishment of ANZTPA, however, faltered in the New Zealand Parliament, and it may not be revisited for some time.
In Australia, pharmaceutical company advertising for prescription medicines, including DAA, currently falls under the jurisdiction of Medicines Australia, a self-regulatory industry body. The Medicines Australia Code of Conduct is designed to complement the requirements of the Act and the TGA Code. Although prior approval of advertisements is not required, there is a monitoring committee, and member companies may be required to submit promotional material for review at various times. Section 9.5 of the Medicines Australia Code of Conduct (15th edition) allows for “patient education”, including advertising or provision of information on medical conditions and the broad range of treatments that may be prescribed by doctors. The Code stipulates that patient education should: be current, accurate, and balanced; not focus on a specific product or treatment; include a statement directing consumers to seek further information about the condition or range of treatments; not encourage patients to seek a prescription for a product; not cause alarm or misunderstanding; and not raise patients’ hopes of successful treatment.
We aimed to determine the nature of DAA in popular Australian magazines, including the types of disease information provided and the use of persuasive techniques, in an effort to inform future regulation of pharmaceutical industry DAA.