Intended for healthcare professionals

Feature Direct to consumer advertising

Industry funded patient information and the slippery slope to New Zealand

BMJ 2007; 335 doi: (Published 04 October 2007) Cite this as: BMJ 2007;335:694
  1. Les Toop, professor,
  2. Dee Mangin, senior lecturer
  1. Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
  1. Correspondence to: L Toop les.toop{at}

Industry funded health information campaigns could become common on our television screens if the European Commission proposals are passed. Les Toop and Dee Mangin warn that Europe could end up with similar problems to those in their country

The European parliament is considering allowing the drug industry to have a much greater role in providing information to patients, with no restriction on the type of media.1 After direct to consumer advertising was rejected in 2002, industry and the commercial arm of the European Commission submitted a new proposal to allow communication between industry and patients that deliberately leaves out the word advertising and replaces the term independence (freedom from commercial influence) with objective. Information can be entirely objective and yet still mislead through incompleteness or lack of balance and context. Opponents believe that industry will not, and cannot be expected to, provide balanced, comparative and comprehensive information,2 and that the proposals amount to advertising by stealth.3 4

In New Zealand and the US, the only two developed countries that allow direct to consumer advertising of prescription medicines, opposition has grown steadily from both the public and doctors. New Zealand's health system is much closer to those in Europe than the US system. So what can we learn from its experience?

Rise of advertising

Unlike most other developed countries, New Zealand never enacted pre-emptive legislation to prevent direct to consumer advertising. The adverts started appearing in the early 1990s, and steadily increased. But the US Food and Drugs Administration relaxation of regulatory requirements for broadcast advertising in 1997, unleashed an explosion in both the US and New Zealand. Last year drug companies spent over $5bn (£2.5bn; €3.6bn) on direct to consumer advertising in the US and tens of millions of dollars in New Zealand.

Opposition grew alongside the advertising, particularly in …

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