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Hungary curbs drug company advertising

BMJ 2001; 322 doi: (Published 21 April 2001) Cite this as: BMJ 2001;322:947
  1. Carl Kovac
  1. Budapest

    Hungary's pharmaceutical manufacturers are facing a clampdown on the methods they use to advertise and market their products to doctors. A health ministry decree, due to become effective within the next few weeks, will drastically limit what has been termed “rampant marketing” by manufacturers. “The era of uncontrolled drug advertising, unsupervised vaccine programmes, leaflets promoting pharmacies, and medications jamming mailboxes is over,” said health minister István Mikola.

    The new decree is seen by the health ministry as essential to bringing down the country's drug costs. The advertising bill for prescription drugs, over the counter medications, and other healing products totalled 11.4bn forints (£26.4m; $39.6m) last year. Promotions for these products, including those aimed at doctors, adds an estimated 50bn forints to the drug bill annually, according to the media research firm Médiagnózis.

    The decree will strictly limit the amount manufacturers spend on conferences and other events—usually held in exotic foreign locations—to promote their products and will prohibit them from paying for doctors' trips to these events. Dr Kinga Karlinger, secretary of the Hungarian Doctors Chamber, said: “Doctors don't like [the decree] because the average general practitioner can't afford to attend conferences abroad without [financial] help, and hospitals can't afford to send their staff doctors.”

    Drug companies will no longer be able to entice doctors with expensive gifts; the cost of such presents will be limited to 1% of Hungary's monthly minimum wage, currently 40000 forints (£93). The decree also limits the number of free pharmaceutical samples doctors may accept and prevents doctors from receiving drug samples directly from manufacturers or importers. Such “freebies” will instead come through the chief pharmacist's office.

    Additionally, representatives of drug companies, most of them doctors on a company's payroll, will be prohibited from pushing their products on fellow doctors during office hours. In Hungary, doctors working for drug firms make several times more than doctors practising medicine, whose average monthly take home income is about 80000 forints. Consequently, the number of medical school graduates forsaking the profession for more lucrative careers as pharmaceutical representatives is growing annually.

    Drug companies are concerned about the decree primarily because they say drug advertising in Hungary is already regulated by advertising and pharmaceutical laws, and the industry code of ethics. Advertising agencies are appalled, contending that the decree is an unlikely remedy for Hungary's ailing healthcare system. A spokesman for one agency called the measures “nonsense” and said the decree would “only give way to more corruption.”

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