TCS Daily


No Ads Please, We're Europeans

By Joshua Livestro - September 20, 2004 12:00 AM

European governments are obsessed with the health of their citizens, and rightly so. Apart from spending hundreds of billions of euros annually on treatment and long-term care, most governments also spend considerable sums on preventive medicine by promoting healthy living and discouraging such unhealthy activities as smoking, drinking, gambling and watching prescription drug advertisements.

Okay, maybe I exaggerate a little. Only prescription drug advertising is deemed to be so dangerous that it is banned outright in the whole EU area. Why this should be so is difficult to understand. After all, products that claim to contribute to a healthy lifestyle -- anything from diets to fitness equipment -- don't fall under the ban. Nor do foodstuffs that could possibly contribute to the treatment or prevention of real medical problems like high cholesterol levels (olive oil) or heart disease (red wine). No matter how dubious the science, as long as you're not actually in the business of saving lives, the airwaves are yours, as is the printed press. Only prescription drugs that have been clinically tested and that have a proven track record in the treatment of life-threatening diseases fall under the ban.

Is this rational, reasonable or fair? Well, no, but then, the European Commission, which is the fount of origin of this directive, is used to being an obstacle to progress. Progress, for instance, in the direction of a truly free society, in which fully emancipated patients are able to inform themselves about the availability of effective medical treatment. Even after three centuries of Enlightenment, Commission officials still see us, the people, as pre-rational creatures, easy prey for malicious drugs companies looking for a quick buck. It seems we need to be protected, against ourselves as much as against the advertisements.

But as Dan Troy, chief counsel of the American Food and Drug Administration argued in a recent debate organized by the Brussels-based think tank Centre for the New Europe (CNE), if European civil servants would be willing to engage in a little experiment in freedom of information for patients, they might be surprised by the outcomes. Seven years of American experience with free DTC (Direct To Consumer) prescription drug advertising has shown that people are actually surprisingly rational when it comes to interpreting prescription drugs advertisements. One conclusion Troy drew from the available data was that reading or viewing an advertisement for a prescription drug makes a patient more likely to seek further treatment and information on available treatments.

In the case of a disease like osteoporosis that would be an extremely welcome development for Europeans. In a recent editorial in the Wall Street Journal Europe, Per Wold-Olson, president of the European Human Health division of Merck & Co. warned that the ban on access to information about available treatments as a result of the ban on drug advertising is deadly. He quoted figures showing that of the 12 million European women suffering from osteoporosis -- a debilitating, painful and potentially fatal disease -- only 2.5 million actually seek effective treatment.

To fans of socialized medicine, patients actually taking steps to seek earlier and better treatment of their medical problems probably sounds like a nightmare scenario: it would put even more pressure on limited government resources. Maybe so, but as the FDA's Troy explains, because patients seek treatment sooner and more frequently, the chances of treatment being effective in preventing the rise of future complications also increases dramatically. In his view, legalizing prescription drug advertising might prove to be an important step in controlling the future costs of health care provision. Short-term pain is likely to lead to long-term gains, both for the patient and for the system as a whole.

The current system in Europe is heavily stacked against the consumer, who works from a paucity of knowledge. Intimidated by doctors in white coats, bureaucrats who are not eager to tell patients about the latest breakthroughs fearing higher consumption, and a medical establishment that believes it knows best, patients find themselves at a deep disadvantage when it comes to discussing their treatment options. Pharmaceutical companies add to the imbalance, because they can only communicate information today to doctors, who are loaded up with knowledge, while patients are kept out. European patients who speak English well and can manipulate the internet can find their way onto US web sites and study up on the latest medical options, but this leaves millions of Europeans in the dark. The system is obviously tilted against consumers in an area that should matter most, our health, but it's transparently corrupt. With everyone except patients happy with the status quo, national legislators don't seem to mind.

What is right in principle -- namely letting people make their own informed decisions about the purchase of medically necessary prescription drugs -- would also be more efficient and more equitable in practice. If new President José Barroso is serious about making freedom the first political priority for his European Commission, he could do worse than starting by lifting this ridiculous ban.


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