Intended for healthcare professionals

Rapid response to:


American Medical Association rejects proposal to ban consumer adverts for prescription medicines

BMJ 2005; 331 doi: (Published 30 June 2005) Cite this as: BMJ 2005;331:7

Rapid Response:

The American Medical Association’s Response to Pharmaceutical Advertising

A recent BMJ news editorial by Jeanne Lenzer showcases the American
Medical Association’s recent decision at its House of Delegates Meeting to
eschew voting on a bill to ban prescription drug advertising in favor of
further deliberation. (1) Despite this disappointing news from the
American Medical Association (of which I am a member), I would hope that
the organization revisits this issue quickly rather than deflect the
decision to a committee quagmire.

While the AMA ponders, I refer its members and readers to a pivotal
article previously used in the decision-making process that ultimately
changed the way pharmaceutical companies were subsequently enabled to
direct their advertising to consumers. The article was written by Alison
Masson, M.A. and Paul Rubin, PhD when Dr. Rubin was working for the US
Federal Trade Commission. It was titled, “Matching Prescription Drugs and
Consumer; The Benefits of Direct Advertising.” The article was published
in the 22 April 1985 edition of the New England Journal of Medicine. (2)
(As a point of reference, Dr. Rubin, a Professor of Economics at Emory
University in Georgia, currently serves many roles, including as an
adjunct scholar at the Washington, D.C. “think tank”, the American
Enterprise Institute. That organization regularly offered advice and
personnel to the administrations of Presidents Richard Nixon and Ronald
Reagan and continues that tradition within the current administration of
President George W. Bush.)

In his April 1985 NEJM commentary, Dr. Rubin reported that direct-to-
consumer drug advertising would beneficially serve the purchaser of
prescription medicines in two (2) ways. First, it would alert and educate
consumers to bring problems and treatments to the attention of their
physicians, problems and treatments of which their physician might not
otherwise be aware. Second, the ‘net’ effect of direct consumer
advertising would likely save money for the consumer because (Dr. Rubin
predicted) the price of pharmaceuticals, if the direct-to-consumer
advertising were sanctioned by the U.S. Food and Drug Administration,
would fall.

Unfortunately, Dr. Rubin’s predictions were neither prescient nor
cost-effective. Doctors have often yielded to consumer pressures to
excessively prescribe pharmaceuticals while the cost of those
pharmaceuticals has incrementally exploded.

The AMA can, in my opinion, reassert its authority and demonstrate it
responsibility to public welfare. It has done this before, i.e., those
times when the AMA dedicated itself to responsible activism (e.g., anti-
smoking campaigns.) The AMA can do this again by seizing the opportunity
to disengage itself from massive marketing schemes (thinly disguised as
consumer education and benefit) and, instead, re-vitalize the physician-
patient relationship by defending the integrity of the prescribing
physician and the welfare of the consuming patient.

Stefan P. Kruszewski, M.D.


Harrisburg, Pennsylvania 17112 USA

(1) Lenzer, J. 2005. (02 July) American Medical Association rejects
proposal to ban consumer adverts for prescription medicines. BMJ 331: 7.
doi: 10.1136/bmj.331.7507.7-a

(2) Masson A. and P. H. Rubin. 1985 (22 April) Matching Prescription
Drugs and Consumers; The Benefits of Direct Advertising. N Engl J Med.
313: 513-15

Competing interests:
None declared

Competing interests: No competing interests

06 July 2005
Stefan P Kruszewski
Harrisburg, Pennsylvania USA