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Orthomolecular Medicine News Service, June 27, 2013

Truth in Pharmaceutical Advertising
Now there is an Oxymoron for You

by Ralph K. Campbell, M.D.

(OMNS June 27, 2013) Advertising is a powerful and effective tool for promoting the sale of products, especially from the drug and food industries, due to their huge profits. Awareness of a need for government to keep advertisers in line goes back to the end of the 19th century. The very first US Pure Food and Drug Act was passed in 1906, when Theodore Roosevelt was president. Currently, the Federal Trade Commission requires that advertising must be "truthful and non-deceptive." Advertisers must have evidence to back up their claims. Advertisements cannot be "unfair," and must inform about anything that may "materially affect" the consumer's decision. However, those terms are not easily defined. And corporations redefine them for their own benefit.

There has been a culture shift. We still like to stick it to the big corporations, but there is little concern for the nuances of false advertising. Many people today don't have the background to discern what they read, and may be inclined to trust a well-constructed ad. Even lawyers can barely determine what is "legal," let alone what is "right." More often, the aim is simply to construct effective advertising that boosts sales irrespective of morality.

Historically the American Medical Association (AMA) was the official "ethics police" for advertising of drugs, hospitals, clinics, individual physicians and medical devices. Initially, most advertising was forbidden. Members of the AMA were fined for violations. Since social standing in the community is important to a practicing physician, this embarrassment was enough to effectively chastise most offenders. Claims of the superiority of one clinic, hospital or specialist over another were rarely made. Advertising of drugs was minimal for many decades, but recently has been growing exponentially. I attribute this to two factors: the pharmaceutical industry's great power and influence on medical practice, and the private insurance industry that provides accessibility of drugs to its clients by covering the cost---whatever it is. The uninformed patient is usually not aware of the actual cost covered by the insurer. This enables a for-profit insurance company to have full say of what expenses are covered, because it does not have to face challenges from those covered.

Use as Directed. . . by the Advertiser

One look at an evening TV news broadcast illustrates this influence. Drug ads, through the efforts of marketing specialists, are presented to specifically targeted audiences. Who watches the 5 o'clock news? Lots of people, including a whole lot of retirement-aged folks. Many are taking numerous prescriptions and over-the-counter (OTC) medications of their choosing. These include everything from an OTC product that helps keep a dental plate where it belongs, to potent immune system modifiers that can have life threatening side-effects. The retired viewer will likely have interest in a drug upon being convinced that it will alleviate a medical condition.

In the world of drug advertising, signs and symptoms and their treatment are organized into specific motifs. After clearly describing the how a drug can help you, without a clear description of its drawbacks, the final admonition is: "Ask your doctor about-----". Of course, since only a doctor can prescribe, this statement becomes a veiled suggestion that the doctor will agree. The problem here is that it is usually better for a patient to get medical information from the doctor, with whom a trusting relationship has been formed, than from an advertisement designed with for maximum profit. In many cases, to fully inform a patient about a disease and its treatment takes hours or even days.

An advertisement from early TV is still prominent in my mind because of its impropriety. A drug that is generally prescribed only by a specialist such as an oncologist should not be advertised. After chemotherapy, many patients are found to be anemic, due to the treatment having interfered with the bone marrow's ability to form new red blood cells (erythrocytes). The process is called erythropoiesis; the stimulating hormone is erythropoietin. Pharmaceutical companies developed a drug that, chemically, is a look-alike of the hormone that is prescribed only when absolutely necessary. Certainly, this is not the kind of drug that is freely dispensed. With all the safeguards from agencies such as the US Food and Drug Administration (FDA), how could this be allowed? A win-at-all-costs culture seems to be the driving force that can affect doctors, athletic event participants and all in between. Unfortunately the FDA is not the watchdog it is cracked up to be.

The Risk is Yours

We joke about ads that loudly proclaim the attributes of the sponsor's specific drug for a disorder, or actual disease, that the viewer is convinced he has, while softly listing the side effects. For example, the ad for the only recognized "stop smoking" drug has such dire warnings that to continue smoking might seem a better choice. Listen carefully for soft enunciation of such words as "occasional fatalities," which might well provide cause for reflection. Because of the savvy marketing from the business end of the drug company, the lawyers, and the PR specialists, the "Fair" Trade Commission never seems to be concerned about such advertising, evidently because it is considered inconsequential.

New drugs are being advertised at an astonishing rate. When a successful drug's patent runs out, and it becomes a generic drug, immediately another company will market their own look-alike with a catchy name. Some of the conditions and drug names may even sound humorous. But I see no humor in advertising an immune system suppressor----a type of drug that is only prescribed after all safer pharmaceuticals have failed. This drug is designed to inhibit tumor necrosis factor (TNF) an active component of a well-functioning immune system. The FDA approves its use for rheumatoid arthritis, ankolosing spondylitis (crippling arthritis of the spine) and psoritic arthritis-----a few of the severe auto-immune diseases. Since it disrupts immune system function, only specialists should prescribe it, and only when they have exhausted all the other possibilities. The warnings about side effects should include the risk that a drug will contribute to the development of new infections or to severe flareups of present infections, and to more serious problems such as inflammation of the optic nerve and heart failure. This type of drug can also cause auto-immune diseases, and even a fast growing type of lymphoma (cancer). The ads gloss over the severity of the side effects, so that the viewer gets the impression that the drug is simply a new and improved super aspirin.

Food Ads

Half-truths are a big part of food advertising as well. The words "natural" and "organic" are freely used, much to the dismay of a real organic farmer who has gone through the certification process. "Free range" chickens--- that are free of depression from living in an overcrowded space, are now happy birds that are able to run around, even if they are fenced in an area without vegetation to provide insects to eat. The size of the "range" is not defined----measured in square feet or inches? Is the range free of chemicals? Powerful companies such as Monsanto and DuPont are doing their best to prevent labeling of GMOs (genetically modified foods), blocking a step that would give consumers the ability to know what they are eating. Monsanto is succeeding on a national level but cannot completely overcome the actions of private organic food producers whose patrons are demanding labeling. What is Monsanto concerned about? Probably this: the European Union has already adopted required labeling of GMO foods. (1)

Everyone knows that making money is the driving force for advertising. Let the consumer beware.



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Editorial Review Board:

Ian Brighthope, M.D. (Australia)
Ralph K. Campbell, M.D. (USA)
Carolyn Dean, M.D., N.D. (USA)
Damien Downing, M.D. (United Kingdom)
Dean Elledge, D.D.S., M.S. (USA)
Michael Ellis, M.D. (Australia)
Martin P. Gallagher, M.D., D.C. (USA)
Michael Gonzalez, D.Sc., Ph.D. (Puerto Rico)
William B. Grant, Ph.D. (USA)
Steve Hickey, Ph.D. (United Kingdom)
Michael Janson, M.D. (USA)
Robert E. Jenkins, D.C. (USA)
Bo H. Jonsson, M.D., Ph.D. (Sweden)
Peter H. Lauda, M.D. (Austria)
Thomas Levy, M.D., J.D. (USA)
Stuart Lindsey, Pharm.D. (USA)
Jorge R. Miranda-Massari, Pharm.D. (Puerto Rico)
Karin Munsterhjelm-Ahumada, M.D. (Finland)
Erik Paterson, M.D. (Canada)
W. Todd Penberthy, Ph.D. (USA)
Gert E. Schuitemaker, Ph.D. (Netherlands)
Robert G. Smith, Ph.D. (USA)
Jagan Nathan Vamanan, M.D. (India)
Atsuo Yanagisawa, M.D., Ph.D. (Japan)

Andrew W. Saul, Ph.D. (USA), Editor and contact person. Email: This is a comments-only address; OMNS is unable to respond to individual reader emails. However, readers are encouraged to write in with their viewpoints. Reader comments become the property of OMNS and may or may not be used for publication.

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