General Public Key Topic 1: Disease Awareness Campaigns
Disease Awareness Campaigns (DACs) provide information, promote awareness or educate the public about health, diseases and their management. In some cases they may help the public recognise symptoms and highlight useful sources of advice.
The primary purpose of a DAC must be to increase awareness and knowledge of a disease. It should not be to promote or raise awareness of a particular treatment.
DACs can make reference to treatment options but the emphasis of the material should be on the condition rather than the treatment. For example a campaign about treatment of osteoporosis could cover aspects such as exercise, diet and nutrition, physical aids (e.g. walking sticks, shoe adjustment), medicines and surgical options.
Where there is only a single product available to treat a condition, or where there are only a small number of treatments, great care must be taken to ensure that the campaign does not appear to be referring (even indirectly) to a particular product.
The company’s involvement in a DAC should always be declared.
Example 1
A member of the public complained about a schizophrenia advertisement placed by Janssen-Cilag in the ‘Big Issue’ magazine. The advertisement told readers that ‘Schizophrenia can be very difficult to live with. But the good news is, with modern treatments there’s now a real chance of recovery. So it’s very important to discuss with your doctor the choices available’.
Janssen-Cilag produced Risperdal (risperidone) and Risperdal Consta (long acting risperidone for intramuscular injection), an atypical antipsychotic. The complainant alleged that the claim ‘the good news is, with modern treatments there’s now a real chance of recovery’ was misleading and untrue.
The advertisement led to a website (oneinonehundred.co.uk) sponsored by Janssen-Cilag which the complainant alleged promoted a prescription-only medicine as ‘long acting injections’ was underlined twice, and ‘atypical antipsychotics’ was underlined three times. This underlining reinforced the link between long-lasting injections and atypical antipsychotics. The complainant noted that Risperdal Consta was the only atypical antipsychotic available as a long-acting injection. Readers were encouraged to ‘ask your doctor if any of the newer treatments for schizophrenia would be suitable for you’.
On examination of the website the underlining of certain terms such as ‘atypical antipsychotics’ was to indicate a link to a glossary of terms.
Which of the following do you agree with?
- ‘real chance of recovery’ in relation to schizophrenia is misleading
- the website encourages members of the public to ask for Risperdal
- websites for the public should not be advertised in this manner
- this raises unfounded hopes in terms of treatment of schizophrenia
Ruling
The Panel considered that some lay people, particularly those who knew very little about schizophrenia, might assume that recovery meant elimination of the illness, particularly as the advertisement referred to a ‘real chance’ of recovery in the context of ‘modern treatments’ and described this as ‘good news’. Schizophrenia is a chronic disease. The advertisement was misleading in this regard.
The Panel noted that whilst the advertisement referred to modern treatments, there was no direct or implied reference to a specific medicine. There were several ‘modern’ treatment choices. The Panel did not consider that the statement at issue promoted a specific prescription medicine to the public or would encourage patients to ask their health professional to prescribe a specific medicine.
Example 2
In Australia The Monitoring Committee referred an information booklet designed for the general public for consideration by the Code Committee. It was alleged that certain text in the booklet was potentially making a claim and a comparison between different products for the treatment of glaucoma.
The booklet, produced by Alcon, was made available to doctors and ophthalmologists for them to give to patients with glaucoma. A patient did not need to be prescribed a particular medicine to receive the booklet.
Under the heading ‘New treatments for Glaucoma’ the booklet referred to ‘a powerful class of drugs (prostaglandins)’, being able to ‘manage glaucoma more effectively’ and that ‘these newer drops ... used just once a day ...easier for people to remember to use them’.
There were a number of eye drops available that contained prostaglandin, supplied by Alcon and other companies. The booklet did not refer to a product by brand name; it only referred to the class of medicines.
Which of the following do you agree with?
- Referring to the general class of medicines is acceptable as there is more than one option within the class
- If the booklet did not mention other classes of drugs available it would not be acceptable
- The statements about drugs containing prostaglandins should be taken in context of the entire booklet
- A booklet of this type should be reserved for patients prescribed an Alcon product and not the general public
Ruling
The majority of members of the Committee considered that the statements referring to new treatments for glaucoma should be considered in light of the entire contents of the booklet, which referred generally to the management of glaucoma with eye drops. They did not consider that the text encouraged a member of the public to seek a prescription for a prescription-only medicine.
They also considered that the reference to prostaglandin eye drops was sufficiently general and it was understood that most people newly diagnosed with glaucoma will be prescribed a prostaglandin eye drop.
However they did state that the booklet was not sufficiently balanced. It unduly emphasised treatment with prostaglandin eye drops and did not mention other treatment options such as other classes of eye drop. Surgical management of glaucoma was also inadequately covered.
Alcon had to pay a fine of $5000 for the lack of balance.
