AMA considers backing limits on ads for prescription drugs


CHICAGO -- Amid increased scrutiny of advertising prescription drugs directly to consumers, the American Medical Association is considering backing a government moratorium on drug ads.

The nation's largest physicians group, representing a quarter of a million doctors, is being asked by its members to lobby for federal legislation that would severely limit TV commercials and print ads targeted at consumers once prescription drugs are approved in the United States

A moratorium -- which would delay the start of an ad after a drug is approved -- is supported by several state and national medical groups within the AMA. Support for such a measure would turn up pressure on the Food and Drug Administration and pharmaceutical companies just as Congress and the FDA weigh how to ensure consumer safety once prescription drugs reach the market.

Doctors who testified at yesterday's annual AMA meeting in Chicago said potentially unsafe prescription drugs are getting into the hands of people who don't need them because of the $4 billion the industry spends annually on TV and print ads aimed at consumers. Most ads mainly urge consumers to talk to their doctors, with the drug's side effects noted in a quiet tagline or voice-over at the end.

"Consumers tend to retain more about the benefits of these medications than the risks," said Dr. Scott Worman, a family practice physician from Oceanside, Calif.

Drugmakers are so concerned about the AMA's stance on consumer advertising that they deployed their Washington lobbying group to Chicago to sway doctors against a recommendation to rein in drug ads.

Dr. Paul Antony, chief medical officer for the Pharmaceutical Research and Manufacturers of America, told AMA members that drug ads have improved awareness of diseases and that they encourage patients to see their doctors. The industry, he said, is on the verge of making voluntary changes.

The FDA's 1997 decision to make it easier for drug companies to tailor commercials for the public opened up the advertising floodgates. Consumer ad spending by pharmaceutical companies has quadrupled from about $1 billion in 1998.

More medical groups want to increase regulation in the aftermath of Merck & Co.'s decision to pull the painkiller Vioxx from the market Sept. 30 after it was linked to increased heart problems. Vioxx was one of the most heavily advertised drugs before it was pulled, and studies have since shown that millions of Americans did not need it. Instead, they could have taken safer drugs that were just as effective and cheaper, studies show.

"Patients are asking for things they don't need," said Dr. Bryan Pechous, an ophthalmologist from Dubuque, Iowa, whose delegation joined with a group from Wisconsin in favor of a ban on drug ads.

Pechous said the money spent on drug ads could be used to lower the high costs of prescriptions or be funneled by drugmakers back into research and development.

But most doctors testified in favor of a moratorium that would allow physicians several months after a drug's approval to discuss the medicine's safety and efficacy profile with their patients before ads hit the airwaves.

A ban, these doctors said, would face significant legal challenges from advertisers and media companies. "You are not going to ban free speech in this country," said Dr. Coy Irvin, a family practice physician from Pensacola, Fla.

The AMA's 543-member House of Delegates will vote as early as today on the measure, one of dozens the group will consider during its meeting, which runs through Wednesday.

But even before the AMA votes, the drug industry lobby said it hears doctors' pleas and is pursuing voluntary changes. Antony said the drugmakers' group would be coming out with a voluntary code of conduct for drug ads next month.

And last week, New York drug giant Bristol-Myers Squibb Co. pledged not to advertise new medicines directly to consumers for at least a year after they are approved.

Bristol spokesman Brian Henry said the company wants to "make sure physicians have a good comfort level and understanding of the company's medicines before they get the request for patients for certain medicines."

The industry's voluntary code is not going to provide for a specific "time-limited" moratorium on such advertising after drug approval, as some AMA members are suggesting. The lobby's spokesman, Ken Johnson, said any moratoriums would be left to each company.

Given moves by Bristol and others in the works, at least one doctor said he doesn't see the need for the AMA to endorse a ban or moratorium.

"Today's Cialis guy is the equivalent of yesterday's Marlboro man," said Dr. John Abenstein, an anesthesiologist from the Mayo Clinic. "I think they are already getting the message."

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