New Zealand is one of only a few developed countries including the US that allows pharmaceutical companies to advertise prescription medicines directly to consumers through television, print and radio media.
This is called direct to consumer advertising (DTC/DTCA). This topic is relevant because it will need to be addressed in the upcoming Therapeutic Products Bill.
I have been critical of this policy in a personal capacity for many years. My observation as a GP is that DTCA consumes precious consulting time, raises expectations, provides low quality biased information and consumes health resources that could be better used elsewhere.
The main points that pharmaceutical companies assert are that it does provide useful consumer information that is approved by the Advertising Standards Authority (ASA) and is nothing that couldn't be found on the web anyway.
They also note that of all DTCA advertising only 15 per cent is prescriptions medicines and the rest are natural health and over the counter products (2017).
A 2007 article in the British Medical Journal by local health experts Prof Les Toop and Dee Mangin entitled, Industry funded patient information and the slippery slope to New Zealand, backgrounds the early development of DTCA in NZ.
They state: "Unlike most other developed countries, New Zealand never enacted pre-emptive legislation to prevent direct to consumer advertising. The adverts started appearing in the early 1990s, and steadily increased."
More recent articles from local authors continue to express concern and the New Zealand Medical Association published a position paper in 2018 firmly against DTCA.
Putting a number on the cost of advertising (2017) reveals $5.5 million was spent in New Zealand by pharmaceutical companies advertising 33 products. These products include vaccines and medicines for multiple sclerosis and erectile dysfunction amongst others.
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Could that $5.5m be better spent elsewhere in the health system, maybe even reducing the cost of some pharmaceuticals or trialling new products for rare diseases?
I recently asked every DHB what their position on DTCA was and if there was a choice what would they prefer to spend the advertising dollar on. I have received early replies from some but not all, but even at this stage a pattern is appearing.
Nelson Marlborough Health (NMH) replied: "NMH has not formed a view on whether DTC is an effective use of the health dollar nor whether there is any preference from clinical teams or the wider population." So apparently this also applies to doctors and patients served by the DHB. I would be interested to test the validity of that position.
West Coast and Canterbury DHBs were cautious but more forthcoming: "We would prefer limitations on DTC." And some of their doctors had actively advocated against the policy, and the DHB thinking was that patients would prefer cheaper pharmaceuticals.
Whanganui DHB was the most pragmatic and decisive. No to DTC, doctors seeing no benefits and patients would prefer cheaper pharmaceuticals.
I will conclude by posing again the question I raised earlier. Could $5.5m of pharmaceutical advertising dollars be better spent elsewhere in the health system? My sense is yes.
• Dr Shane Reti is MP for Whangārei.