Members of the International Society of Drug Bulletins (ISDB


Mrs. Rosemarie Müller
Member of the European Parliament

Mrs. Francoise Grossetête
Member of the European Parliament

Mrs. Ulla Schmidt
German Federal Ministry of Health

Members of the Health Commission of the European Parliament

Members of the Health Commission of the German Lower House (Deutscher Bundestag)

Modification of European Union legislative for drugs, KOM(2001) 404, Directive 2001/0253 Article 88

OPEN LETTER

The European Union plans to relax the prohibition of advertising on prescription drugs. The pharmaceutical industry in future shall be allowed to "inform" patients. The European Commission's draft would make possible DTCA direct-to-consumer-advertising for prescription drugs, initially for three diseases: Diabetes, Asthma and AIDS. The European Commission gives the wrong impression that this would mean only passing on of "information" and not advertising.

The job of independent drug bulletins is one of providing scientific and unbiased information on therapeutic options to enable the rational use of drugs in medical practice. We finance ourselves only by subscribers, partly by grants from independent institutions , and don't depend on industry.

The independent drug bulletins have great concerns about pharmaceutical industry as a reliable source of information for patients. Independent information is an indispensable condition for rational use of drugs.

During our editorial work we deal with information given by pharmaceutical industry. Unfortunately we have to ascertain that the information by industry in many cases is selective, misleading and unbalanced. Scientific editors are able to check such "information" and expose the truth. Patients and consumers without this scientific knowledge mostly cannot judge the truth (e.g. BAYER's marketing strategy for Lipobay).

Information by industry or even as DTCA is a step into the wrong direction. Up till now DTCA is allowed only in USA and New Zealand. The consequences: irrational practice of prescribing and extremely increasing spending on drugs without improving quality of health care. In 1998 in the US more than half of television advertisements violated laws.

The initiative for changing the EU rules for advertising has its origin clearly in the pharmaceutical industry. It even uses apparently independent patient groups for its interests. The most recent example is a study by the International Alliance of Patient Organisations (IAPO), that talks for the industries "right" to inform patients. The IAPO was founded and financed by around 30 drug companies.

The survey was done mostly with IAPO members, it was sponsored by an advertising agency and a consulting company. The result of this study as interpreted by the industry: patients don't trust in doctors and pharmacists. But the original data doesn't support this statement: 60% of the patients have high confidence in their doctor, further 33% trust them sometimes. Unfortunately the study doesn't report if patients trust the information given by industry.

In this connection a study by the British Consumers' Association is very interesting (Hunter, M.: BMJ 2002, 324, 1416). Only one quarter of the surveyed patients believe that industry gives well balanced and extensive information and therapies. More than 80% think that companies would focus their advertising on the most profitable drugs. More than half of the surveyed fear that companies would try to convince healthy people to have not-existent diseases.

Even now with with the existing EU laws companies ignore the prohibition on DTCA in many cases. One example is Pfizer's TV ad broadcasted during soccer world championship: soccer star Pelé tells the viewer to go to a doctor in case of erectile dysfunction.

Relaxing the prohibition on advertising would increase the industries possibilities for furthering misinformation. Product promotion by advertising will not improve health care. Disinformation about different therapeutic options worsens health care. Advertising described as information endangers quality.
Patients need to be informed, not misinformed by advertising. Good information is possible without changing the existing law. The need of the hour is more independent information for both experts and consumers.

One carrier for independent drug information also could be package information if their design, readability and content of information would be better coordinate between manufacturers and government regulating authorities. Here we need more European initiative. There are working groups very active on this field.

We would like to use your office so that in future the prohibition of drug advertising for prescription drugs remains in the European legislation and will not be relaxed.

Yours sincerely