Canada may be forced to allow direct to consumer advertisingBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7556.1469-a (Published 22 June 2006) Cite this as: BMJ 2006;332:1469
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(suing to expand its direct to consumer [DTC] drug related ads) and Pfizer
are both among the $100,000+/yr 'platinum supporters' of the Heart and Stroke Foundation of Canada (HSF,
2005 annual report).
With this financial support, the media giant may protect revenues from the ongoing DTC fear-of-death cholesterol campaign by Pfizer, while the latter gets to show the HSF logo on the ad and website to which the campaign refers: MakingTheConnection.ca
Canadian rules don't require the advertiser's name to appear and it was indeed removed from a similar ad after 2001 (PfizerMorgueAdCanada.jpg).
However, the Pfizer logo reappeared on the 2003 version run in France (PfizerMorgueAdFrance.gif)
It was that ad members of the Department of Essential Drugs and Medicines Policy of the World Health Organization [WHO] believed was caught by the WHO Ethical Criteria for Medicinal Drug Promotion and which they characterised misleading and unethical in
Vol 362 Aug. 30 2003:747.
The current Canadian consumer ad (PfizerPoolSharkAdCanada2006.pdf)
is a poster child of such indirect drug sale promoting strategy again using the fear-of-death; it shows a man with a tall drink floating in a backyard pool blissfully unaware of the large shark behind him: "Living with high cholesterol You could be surprised what's lurking beneath".
While creating fear of premature death, the reality is that meta-analysis in 2004 JAMA and JACC both concluded that cholesterol-lowering has no mortality benefit in women, while the PROSPER trial showed the same in high-risk men and women over age 70 (ref's 3, 4 and 6 in 1, respectively). Moreover, it is known since 1990 that serum cholesterol is not an all-cause or coronary artery disease mortality risk for men in the area of Canada where this was actually studied, and where the ads are shown (2).
It would seem that indirectly promoting drugs using DTC advertising in a way that does not respect ‘the ethical criteria’ of the WHO, namely, being accurate, informative and balanced, is a problem that not only escapes control in Canada, but is defended on the grounds of free speech. Freedom to advertise is freedom to mislead as this campaign has shown.
1. Vos E, Rose CP. Questioning the benefits of statins. CMAJ
Nov. 8 2005;173.
2. Dagenais GR, Ahmed Z, Robitaille NM, Gingras S, Lupien PJ et al. Total and coronary heart disease mortality in relation to major risk factors -- Quebec cardiovascular study. Can
J Cardiol. 1990 Mar;6(2):59-65.
Competing interests: No competing interests