After a survey of physician satisfaction with sales reps, a marketing agency revealingly concluded that: "there is a direct relationship between the number of contacts established by a drug company and the number of subsequent prescriptions " (Rev Prescrire 306).

At the same time, drug companies continued to drive home their advertising messages to patient groups and the general public in 2009.

Companies and patient associations: dangerous liaisons. Drug companies are increasingly focusing their marketing strategies on patient groups (Prescrire Int 102). They infiltrate these groups in order to place pressure on regulatory agencies, through the patients, with a view to obtaining more rapid market access and higher prices for their products. Some groups accept drug company funding or participation in "therapeutic education" (Prescrire Int 105 page 43).

Yet patient groups that accept funding from drug companies risk losing their credibility in the eyes of the authorities, healthcare professionals, patients, and the public.

For example, a bulletin published by one such group contained a drug company proposal to provide information on multiple sclerosis; the company in question markets only two drugs in France, both for multiple sclerosis (Rev Prescrire 307).

TV programme sponsorship by drug companies: another propaganda tool
On 1 January 2009, sponsorship of television programmes by drug companies marketing prescription drugs was authorised in France (Rev Prescrire 312). Although it is limited to the promotion of a company’s name and image (and does not include its drugs) TV sponsorship is a yet another means of getting the public’s attention.

Misleading advertisements: still too numerous
In 2009, we examined 10 drug advertisements aimed at healthcare professionals that were banned by the French drug regulatory agency, mainly because they promoted off-licence use or minimised adverse effects (Rev Prescrire 308, Rev Prescrire 314).

Many ads placed in professional journals hide or do not mention serious adverse effects.

Thus, publicity for the reimbursement of a so-called third-generation combined oral contraceptive failed to mention an increase in thromboembolic adverse effects (Rev Prescrire 313). Similarly, ads for tramadol + paracetamol (Rev Prescrire 311) and a nasal vasoconstrictor (Rev Prescrire 314) listed serious adverse effects in barely visible, small print while claimed benefits were highlighted. Another advertisement, for fondaparinux, refers readers to the French datasheet compendium for details of adverse effects (Rev Prescrire 303).

©Prescrire April 2010

Source: "A look back at 2009: one step forward, two steps back" Prescrire Int 2010; 19 (106): 89-94.

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