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      Publicidad y promoción de medicamentos: regulaciones y grado de acatamiento en cinco países de América Latina Translated title: Drug advertising and promotion: regulations and extent of compliance in five Latin American countries

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          Abstract

          OBJETIVO: Analizar las distintas regulaciones sobre promoción de fármacos y su grado de acatamiento reflejado en piezas publicitarias expuestas al público en Argentina, Colombia, Ecuador, Nicaragua y Perú. MÉTODOS: Se recogieron 683 piezas promocionales expuestas en establecimientos de salud, farmacias y en la vía pública, de las cuales 132 piezas seleccionadas al azar fueron objeto de análisis. Se examinaron las regulaciones sobre publicidad farmacéutica -incluidas sus coincidencias con los criterios éticos de la Organización Mundial de la Salud (OMS)- tomadas de los sitios web oficiales y mediante entrevistas con los responsables de los organismos regulatorios y ministerios de salud de los cinco países del estudio. Se evaluaron los contenidos de los materiales de la muestra para determinar su grado de acatamiento respecto a las regulaciones nacionales y las recomendaciones sobre promoción de medicamentos de la OMS. RESULTADOS: Los países cuentan con regulaciones que incorporan los criterios éticos de la OMS. Más de 80% de las piezas analizadas incluían las indicaciones del fármaco y más de 70% omitían información sobre efectos adversos. Cincuenta por ciento de los anuncios de medicamentos de venta libre (MVL) expuestos en farmacias incluían indicaciones no aprobadas por la autoridad sanitaria correspondiente. En los anuncios expuestos en farmacias, no se hallaron diferencias significativas entre los riesgos de la información inadecuada con relación a su condición de venta (MVL o medicamentos de venta con prescripción médica). El riesgo relativo de ausencia de información sobre posología fue de 2,08 (intervalo de confianza de 95% 1,32-3,39) en las piezas distribuidas en farmacias, comparadas con las expuestas en establecimientos de salud. CONCLUSIONES: Si bien en general los cinco países del estudio incorporan en sus regulaciones sobre promoción y publicidad de medicamentos las recomendaciones de la OMS, con frecuencia dichas ordenanzas no se reflejan en los contenidos de las piezas promocionales.

          Translated abstract

          OBJECTIVE: To analyze differing regulations regarding drug promotion, and the extent of compliance as seen in samples of advertising directed to the public in Argentina, Colombia, Ecuador, Nicaragua, and Peru. METHODS: A total of 683 pieces of promotional material on display in health facilities, pharmacies, and on the street were collected, 132 of which were randomly selected for analysis. The regulations governing pharmaceutical advertising, taken from official websites and interviews with regulatory officials and Ministry of Health staff in the five countries covered, were reviewed, along with their adherence to the ethical criteria of the World Health Organization (WHO). The contents of the materials in the sample were evaluated to determine their degree of compliance with national regulations and WHO recommendations on drug promotion. RESULTS: The countries have regulations incorporating WHO ethical criteria. Over 80% of the material analyzed included the indications for the drug, while over 70% omitted information on adverse effects. Fifty percent of the advertisements for overthe-counter (OTC) drugs on display in pharmacies listed indications not approved by the relevant health authority. In advertising in pharmacies, the risks from inadequate information were not found to differ significantly for OTC or prescription medications. Compared with materials provided in health facilities, the relative risk of the absence of information on dosage in the material distributed in pharmacies was 2.08 (confidence interval 95% 1.32-3.39). CONCLUSIONS: Although regulations on drug promotion and advertising in the five countries studied generally incorporate the WHO recommendations, promotional materials often fail to reflect the fact.

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          Most cited references47

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          Influence of patients' requests for direct-to-consumer advertised antidepressants: a randomized controlled trial.

          Direct-to-consumer (DTC) advertising of prescription drugs in the United States is both ubiquitous and controversial. Critics charge that it leads to overprescribing, while proponents counter that it helps avert underuse of effective treatments, especially for conditions that are poorly recognized or stigmatized. To ascertain the effects of patients' DTC-related requests on physicians' initial treatment decisions in patients with depressive symptoms. Randomized trial using standardized patients (SPs). Six SP roles were created by crossing 2 conditions (major depression or adjustment disorder with depressed mood) with 3 request types (brand-specific, general, or none). Offices of primary care physicians in Sacramento, Calif; San Francisco, Calif; and Rochester, NY, between May 2003 and May 2004. One hundred fifty-two family physicians and general internists recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%. The SPs were randomly assigned to make 298 unannounced visits, with assignments constrained so physicians saw 1 SP with major depression and 1 with adjustment disorder. The SPs made a brand-specific drug request, a general drug request, or no request (control condition) in approximately one third of visits. Data on prescribing, mental health referral, and primary care follow-up obtained from SP written reports, visit audiorecordings, chart review, and analysis of written prescriptions and drug samples. The effects of request type on prescribing were evaluated using contingency tables and confirmed in generalized linear mixed models that accounted for clustering and adjusted for site, physician, and visit characteristics. Standardized patient role fidelity was excellent, and the suspicion rate that physicians had seen an SP was 13%. In major depression, rates of antidepressant prescribing were 53%, 76%, and 31% for SPs making brand-specific, general, and no requests, respectively (P<.001). In adjustment disorder, antidepressant prescribing rates were 55%, 39%, and 10%, respectively (P<.001). The results were confirmed in multivariate models. Minimally acceptable initial care (any combination of an antidepressant, mental health referral, or follow-up within 2 weeks) was offered to 98% of SPs in the major depression role making a general request, 90% of those making a brand-specific request, and 56% of those making no request (P<.001). Patients' requests have a profound effect on physician prescribing in major depression and adjustment disorder. Direct-to-consumer advertising may have competing effects on quality, potentially both averting underuse and promoting overuse.
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            Martindale: The Complete Drug Reference

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              Drugs in the news: an analysis of Canadian newspaper coverage of new prescription drugs.

              Patients routinely cite the media, after physicians and pharmacists, as a key source of information on new drugs, but there has been little research on the quality of drug information presented. We assessed newspaper descriptions of drug benefits and harms, the nature of the effects described and the presence or absence of other important information that can add context and balance to a report about a new drug. We looked at newspaper coverage in the year 2000 of 5 prescription drugs launched in Canada between 1996 and 2001 that received a high degree of media attention: atorvastatin, celecoxib, donepezil, oseltamivir and raloxifene. We searched 24 of Canada's largest daily newspapers for articles reporting at least one benefit or harm of any of these 5 drugs. We recorded the benefits and harms reported and analyzed how such information was presented; we also determined whether clinical or surrogate outcomes were mentioned; if and how drug effects were quantified; whether contraindications, other treatment options and costs were mentioned; and whether any information on affiliations of quoted interviewees and potential conflicts of interest was presented. Our search yielded 193 articles reporting at least one benefit or harm for 1 of the 5 drugs. All of the articles mentioned at least one benefit, but 68% (132/193) made no mention of possible side effects or harms. Only 24% (120/510) of mentions of drug benefits and harms presented quantitative information. In 26% (31/120) of cases in which drug benefits and harms were quantified, the magnitude was presented only in relative terms, which can be misleading. Overall, 62% (119/193) of the articles gave no quantification of the benefits or harms. Thirty-seven (19%) of the 193 articles reported only surrogate benefits. Other information needed for informed drug-related decisions was often lacking: only 7 (4%) of the articles mentioned contraindications, 61 (32%) mentioned drug costs, 89 (46%) mentioned drug alternatives, and 30 (16%) mentioned nondrug treatment options (such as exercise or diet). Sixty-two percent (120/193) of the articles quoted at least one interviewee. After exclusion of industry and government spokespeople, for only 3% (5/164) of interviewees was there any mention of potential financial conflicts of interest. Twenty-six percent (15/57) of the articles discussing a study included information on study funding. Our results raise concerns about the completeness and quality of media reporting about new medications.
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                Author and article information

                Journal
                rpsp
                Revista Panamericana de Salud Pública
                Rev Panam Salud Publica
                Organización Panamericana de la Salud (Washington, Washington, United States )
                1020-4989
                1680-5348
                February 2011
                : 29
                : 2
                : 76-83
                Affiliations
                [04] Bogotá orgnameFundación Sanitas Internacional orgdiv1Instituto de Investigaciones Colombia
                [05] Washington D.C. orgnameOrganización Panamericana de la Salud Estados Unidos de América
                [03] orgnameFundación Femeba orgdiv1Grupo Argentino para el Uso Racional de Medicamentos
                [02] Bogotá orgnameFundación Ifarma orgdiv1Acción Internacional por la Salud Colombia
                [01] Bogotá orgnameUniversidad Nacional de Colombia orgdiv1Red para el Uso Adecuado de Medicamentos Colombia cpvacag@ 123456bt.unal.edu.co
                Article
                S1020-49892011000200002 S1020-4989(11)02900202
                10.1590/s1020-49892011000200002
                b0b8c7c1-47e5-4316-9022-108ffe7286ea

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 14 May 2010
                : 01 November 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 8
                Product

                SciELO Public Health

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos de Investigación Original

                Colombia,Drug publicity,Publicidad de medicamentos,Ecuador,Argentina,ethics, pharmacy,Nicaragua,control de la publicidad de productos,products publicity control,Peru,ética farmacéutica,nonprescription drugs,Latin America,América Latina,medicamentos bajo prescripción,prescription drugs,medicamentos sin prescripción,Perú

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