News

Incontinence campaign tests limits of advertising rules

Clare Dyer, legal correspondent , BMJ

The first television commercial in a nationwide campaign in the United Kingdom designed to raise awareness of incontinence was aired this week. The campaign, which is being mounted by a leading drug company, has raised fears that it might spearhead a development which will increase pressure on the already overstretched NHS drugs budget.

The £1m ($1.6m) campaign by Pharmacia and Upjohn, manufacturer of the incontinence drug Detrusitol (tolterodine tartrate), will test the rules banning the advertising of prescription only drugs direct to the public, and the outcome is being closely watched by other pharmaceutical companies.

Posters and magazine and newspaper advertisements have already appeared, advising people who are incontinent, and who may be reluctant to consult their doctors, that their condition may be treatable.

The first television advertisement was screened on 1 September, during the soap opera Coronation Street, which has more than 14 million viewers. Pharmacia and Upjohn's drug, one of four available to treat incontinence, is not named but the company's name and logo appear.

Roy Sutherwood, the company's director of public affairs, said that it had submitted the advertisements to the Medicines Control Agency, which had taken the view that they were not banned by the Medicines Act.

The campaign is backed by the Royal College of Nursing, the Patients Association, and groups representing people aged over 50 and those who are incontinent.

Former nurse Claire Rayner, president of the Patients Association, whose voice is heard on the television advertisements, said: "A public education campaign is the only way to break through the social stigma associated with bladder problems and encourage people to seek help for conditions that they may never have discussed before."

GlaxoWellcome, which manufactures Zyban (bupropion), a drug developed as an antidepressant but which has been found to help people stop smoking, and the new flu treatment Relenza (zanamivir), has said that it might run similar awareness campaigns. So has AstraZeneca, which has already run a campaign in France in support of its migraine drug Zomig (zolmitriptan).

But doctors fear that this development could lead to a huge demand from patients and focus attention on a few conditions to the detriment of others. Dr Simon Fradd, a general practitioner and chairman of the BMA's Doctor Patient Partnership, said drug companies would need to ask doctors for "both technical advice and advice on the implications for the service." He said that the partnership was consulting with GlaxoWellcome on the launch of Relenza.

Joe Collier, professor of medicines policy at St George's Hospital School of Medicine in London, said: "The NHS is an integrated whole and a consolidated campaign as powerful as this can distort provision and should not go unchecked."

Similar disease awareness campaigns in the United States were followed by a decision by the Food and Drug Administration in 1997 to lift the ban on advertising prescription only medicines direct to the public.

(Credit: SAATCHI & SAATCHI HEALTHCARE) A cafe scene from an advert for an incontinence drug