Hon Annette King Speech Notes

Firstly, I would like to thank the Advertising Standards Authority and the Association of New Zealand Advertisers for inviting me to speak to you today and for convening this Forum.

The issue of direct-to-consumer advertising (DTCA) is highly controversial, as we all know, as well as being a multi-million dollar business, and having just come off a week of controversy over the health bill, maybe I should be seeking light relief, not more drama.

Seriously, however, I am pleased to be here. Today presents a great opportunity to open up dialogue between those with an interest in DTCA for prescription medicines and to discuss the recent release of a Ministry of Health discussion document on the issue.

As I said, we are all aware that direct-to-consumer advertising is an issue that can be controversial. It is pleasing, therefore, to see that all sides of the debate are represented here today.

But before I start, a little scene setting might be useful

As you are all aware, DTCA for prescription medicines refers to promotional material transmitted via television, radio, newspapers, magazines and the Internet, as well as a range of ‘patient education promotional activities’ generated for the purpose of marketing prescription medicines.

DTCA of prescription medicines in New Zealand is a relatively new and growing phenomenon. Expenditure in New Zealand on prescription and over the counter DTCA is estimated to be in the order of $48 million during 2000, up 41.7 percent on 1999.

However, in the last two to three years the increasing use of DTCA on television and radio and in print in New Zealand has focused attention on the debate over its influence and led to calls for it to be banned.

The aim of all prescription drug advertising is to increase sales. The policy debate has been forced because of the possible ‘side effects’ of this advertising and questions raised about DTCA’s impact on:

1. individual and public health
2. the appropriateness or inappropriateness of pharmaceutical use
3. the patient/doctor relationship
4. overall health care costs.

The United States and New Zealand are the only industrialised countries that allow DTCA of prescription medicines.

At present, New Zealand’s DTCA regulatory framework relies on industry self-regulation, with a fallback to legislative action in cases of non-compliance. All advertisements must comply with the Medicines Act 1981 and Medicines Regulations 1984, monitored by Medsafe.

Other legislation covering prescription medicine advertising includes the Commerce Act 1986, which establishes the legal competitive environment within which prescription advertisers operate; the Fair Trading Act 1986, which legislates against unfair advertising; the Misuse of Drugs Act 1975, Consumer Guarantees Act 1994, Privacy Act 1993, and Health Information Privacy Code 1994 which impact on how the pharmaceutical industry markets and sells prescription drugs.

It is interesting to note that Australia prohibits the advertising of prescription drugs to the public. A recent review concluded that it could not support a relaxation of the current prohibition as “that would result in a situation such as those occurring in the United States and New Zealand, which cannot be assessed as providing a net public benefit, despite some individuals being helped”. Like the majority of other countries, Australia relies on industry self-regulation of promotion.

Yet it is also interesting that the United States has never had any legislation specifically prohibiting the advertising of prescription drugs to the public. Last year the FDA stated that it was “unaware of any data supporting the assertion that public health or animal health is being harmed, or is likely to be harmed, by the Agency’s actions in facilitating consumer-directed broadcast advertising”.

I also note that reviews are being conducted in Europe and Canada.

DTCA of Prescription Medicines Discussion Document

Early this year I requested the Ministry of Health to undertake a review on direct to consumer advertising of prescription medicines. As you will all be aware, I do have some concerns about this type of advertising and therefore wanted the issue to be investigated further.

The specific terms of reference of the review are to ensure that New Zealand has a DTCA policy that is:

 in the best interests of New Zealand consumers
 safe
 as practicable and as cost-effective as possible.

Last week, the Ministry of Health released a discussion document on DTCA of Prescription Medicines. This document is the first stage in the policy debate.

I would like to stress that the purpose of the document, like this Forum, is to provide a basis for discussion, and to allow the opportunity for feedback. This feedback will contribute to advice given by the Ministry of Health to me on whether there should be changes to the current regime of DTCA of prescription medicines in New Zealand, and if so, what these changes might be.

The discussion document reports on views held by stakeholder groups, the current policies in New Zealand and elsewhere in the world, and provides analyses of policy and legislative options. It raises important questions, such as: Does DTCA

 improve or not improve people’s access to some information?
 raise or not raise fiscal pressures?
 damage, preserve or enhance the doctor/patient relationship?
 encourage or not encourage the medicalisation of the population?

I urge you to give these issues your considered appraisal. We are also very interested in your thoughts on any areas that you believe are important and should be considered in the review. Submissions close on the 14 February next year. After the submissions have been analysed, the Ministry of Health will be providing me with advice on the future direction of DTCA. I expect to receive this in March 2001.

The Government seeks a high performing health system in which people have confidence. We are committed to providing a safe environment for consumers --- one in which New Zealanders can make informed decisions about their health guided by appropriate and accurate information.

We are also committed to a non-commercial, collaborative environment that encourages cooperation on common goals. A key aspect of the Government’s health strategy is the need for us to work together and an important part of this is ensuring that community and consumer involvement is encouraged at all levels.

The primary decision that will determine the future of DTCA in New Zealand hinges on the question: Is it in the best interests of New Zealanders for there to be advertising of prescription drugs direct to the consumer, or is banning this type of advertising preferable?

You all can play an important role in this policy review by working together, sharing your knowledge, resources and expertise. This Forum presents an ideal opportunity for you to share your ideas, research and specialist knowledge with each other. Every one of you has a valuable contribution to make to this discussion.

I wish you well in grappling with this issue and I look forward to hearing the results of this Forum.

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