Drug advertisers still in the dark ages

Pharmaceutical advertisers reluctant to embrace medium shifts seen in other sectors.

Pharmaceutical advertising is often a subject of controversy. In the UK (and, indeed, in most other countries), we are shielded from its more direct forms thanks to EU regulations which prevent direct-to-consumer (DTC) advertising of prescription drugs. In the US, however, pharmaceutical companies face no such restrictions; from unsettling and often ill-judged TV ads to drug slogans plastered across every billboard, DTC advertising in the US is endemic.

Americans are bombarded daily with adverts for products across the whole spectrum of pharmaceuticals. From cancer treatments and psychotropics to drugs for erectile dysfunction and weight loss, DTC adverts for prescription drugs are as prevalent as those for beauty products and ‘this-weekend-only’ deals on furniture. This kind of blanket advertising is not without its merits:  many argue that DTC marketing in the US is many people’s main source of information about new drugs and, indeed, may prompt some patients to seek treatment for a disease they didn’t even know they had. This mass-marketing might is also DTC advertising’s weakness: as pharmaceutical marketers cannot exclusively target their intended treatment-seekers, the majority of the audience feel excluded and apathetic. These drugs aren’t for them.

Not everyone thinks that DTC advertising is strictly ethical, despite the stringent rules outlined by the US Food and Drug Administration (FDA). Indeed, the US regulator has often had to order pharmaceutical companies to discontinue DTC advertising campaigns . An example of this is the recent reminder ad for an insomnia drug from Takeda with the tagline: “Rozerem would like to remind you that it’s back to school season.” The ad featured images of children in schools: in slightly poor taste, since the safety information included with the drug stated that: “It is not known what effect chronic or even chronic intermittent use of Rozerem may have on the reproductive axis in human development.”

There is also a view that suggests DTC advertising may be to blame for the rise in healthcare costs. Only the newest and most expensive drugs justify the massive budgets associated with advertising through traditional media channels. Patients are therefore encouraged to ask their prescriber – who themselves receive direct marketing from drug reps – for these premium treatments, potentially driving up the costs of healthcare insurance.

But DTC marketers are advertising dinosaurs: homes in the developed world have been swamped with advertising for decades. Traditional advertising channels are getting old, their possibilities all but exhausted. With the advent of modern technology and continuing evolution (and uptake) of social media, there are newer, fresher ways of influencing and targeting interested consumers. DTC advertisers are lagging behind in this respect. They have only just begun to venture online and build multi-layered, multi-channel campaigns with a view to engaging directly with the patient. This is partly due to the lack of guidance from the FDA: the regulator is yet to provide clear rules as to what exactly allowed in the online advertising space. However, there is also the question as to why a pharmaceutical giant would want to engage its customers in this direct manner, when one angry patient’s feedback through social media could lead to millions of dollars in lost revenue.

Ultimately, regardless of questions of ethics or effectiveness, DTC marketing is a hugely influential part of the US pharmaceutical industry, with over $4 billion spent in 2011 alone. However, times are changing. Unless DTC marketers are able to change and adapt to the new standard in advertising – capitalizing on the growth of online media in the process – they may soon face extinction.

Kimberley Carter is a Life Sciences Analyst at GBI Research.

Photograph: Getty Images

Kimberley Carter is a Life Sciences Analyst at GBI Research.

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The deafening killer - why noise will be the next great pollution scandal

A growing body of evidence shows that noise can have serious health impacts too. 

Our cities are being poisoned by a toxin that surrounds us day and night. It eats away at our brains, hurts our hearts, clutches at our sleep, and gnaws at the quality of our daily lives.

Hardly a silent killer, it gets short shrift compared to the well-publicised terrors of air pollution and sugars food. It is the dull, thumping, stultifying drum-beat of perpetual noise.

The score that accompanies city life is brutal and constant. It disrupts the everyday: The coffee break ruined by the screech of a line of double decker buses braking at the lights. The lawyer’s conference call broken by drilling as she makes her way to the office. The writer’s struggle to find a quiet corner to pen his latest article.

For city-dwellers, it’s all-consuming and impossible to avoid. Construction, traffic, the whirring of machinery, the neighbour’s stereo. Even at home, the beeps and buzzes made by washing machines, fridges, and phones all serve to distract and unsettle.

But the never-ending noisiness of city life is far more than a problem of aesthetics. A growing body of evidence shows that noise can have serious health impacts too. Recent studies have linked noise pollution to hearing loss, sleep deprivation, hypertension, heart disease, brain development, and even increased risk of dementia.

One research team compared families living on different stories of the same building in Manhattan to isolate the impact of noise on health and education. They found children in lower, noisier floors were worse at reading than their higher-up peers, an effect that was most pronounced for children who had lived in the building for longest.

Those studies have been replicated for the impact of aircraft noise with similar results. Not only does noise cause higher blood pressure and worsens quality of sleep, it also stymies pupils trying to concentrate in class.

As with many forms of pollution, the poorest are typically the hardest hit. The worst-off in any city often live by busy roads in poorly-insulated houses or flats, cheek by jowl with packed-in neighbours.

The US Department of Transport recently mapped road and aircraft noise across the United States. Predictably, the loudest areas overlapped with some of the country’s most deprived. Those included the south side of Atlanta and the lowest-income areas of LA and Seattle.

Yet as noise pollution grows in line with road and air traffic and rising urban density, public policy has turned a blind eye.

Council noise response services, formally a 24-hour defence against neighbourly disputes, have fallen victim to local government cuts. Decisions on airport expansion and road development pay scant regard to their audible impact. Political platforms remain silent on the loudest poison.

This is odd at a time when we have never had more tools at our disposal to deal with the issue. Electric Vehicles are practically noise-less, yet noise rarely features in the arguments for their adoption. Just replacing today’s bus fleet would transform city centres; doing the same for taxis and trucks would amount to a revolution.

Vehicles are just the start. Millions were spent on a programme of “Warm Homes”; what about “Quiet Homes”? How did we value the noise impact in the decision to build a third runway at Heathrow, and how do we compensate people now that it’s going ahead?

Construction is a major driver of decibels. Should builders compensate “noise victims” for over-drilling? Or could regulation push equipment manufacturers to find new ways to dampen the sound of their kit?

Of course, none of this addresses the noise pollution we impose on ourselves. The bars and clubs we choose to visit or the music we stick in our ears. Whether pumping dance tracks in spin classes or indie rock in trendy coffee shops, people’s desire to compensate for bad noise out there by playing louder noise in here is hard to control for.

The Clean Air Act of 1956 heralded a new era of city life, one where smog and grime gave way to clear skies and clearer lungs. That fight still goes on today.

But some day, we will turn our attention to our clogged-up airwaves. The decibels will fall. #Twitter will give way to twitter. And every now and again, as we step from our homes into city life, we may just hear the sweetest sound of all. Silence.

Adam Swersky is a councillor in Harrow and is cabinet member for finance. He writes in a personal capacity.