Aricept advertisement breached code

BMJ 1998; 317 doi: (Published 19 September 1998) Cite this as: BMJ 1998;317:766
  1. Jacqui Wise
  1. BMJ

    An advertisement for donepezil (Aricept) breached the advertising code of practice and did not give a balanced view of the data, the Prescription Medicines Code of Practice Authority has ruled.

    The advertisement, which was published in the BMJ and other medical journals, was headed “Mum has Alzheimer's,” beneath which was a large coloured photograph of an elderly woman and her daughter, both smiling. Partially superimposed on the top right hand corner of this photograph was a much smaller photograph of the daughter looking worried. Beneath the larger photograph was the caption, which ran on from the main heading, “but she knew I was calling today.”

    Dr Trisha Greenhalgh, a London GP, wrote a letter published in the BMJ that the advertisement “is a powerful claim for efficacy in a condition currently believed to be incurable and relentlessly progressive” (13 December 1997, 1623). Referring to the published trial cited in the advertisement, she said that it was highly likely that the differences attributed to the intervention could have arisen by chance. Dr Greenhalgh's complaint, along with a similar complaint from another GP, was then taken up by the panel.

    The panel ruled that the code had not been breached but later reversed that decision on appeal. The appeal board decided that the advertisement gave the impression that the patient's memory improved after treatment with donepezil. The panel said: “There were insufficient data to support the impression given by the advertisement that memory in particular improved following treatment with Aricept. The advertising was not a balanced view of the data.”

    Dr Greenhalgh said: “Of all health professionals, GPs are probably best placed to gauge the hopes and fears of their patients. Carers of elderly demented patients clutch at straws, and there is a heavy pressure to offer a ‘wonder drug' to demonstrate empathy and be seen to be doing something active. Misleading claims of efficacy are hard to prove, and GPs are often underconfident in challenging advertisements that appear to be scientifically based.”

    She added that making a complaint about an advertisement is straightforward as you don't need to make the scientific case against the advertisement yourself but simply need to say that the advertisement looks as if it might be unsound--for example, because it is misleading, incomplete, or offensive.

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