Direct-to-Consumer Advertising of Prescription Drugs in Canada: What are the Public Health Implications?

AuthorsMintzes B
SourceToronto (ON): Health Council of Canada; 2006.
ISBN0-9739725-6-4
AbstractDirect-to-consumer advertising of prescription drugs (DTCA) is prohibited in Canada, as in most industrialized countries. Only two countries allow such advertising, New Zealand and the United States. However, three major consultations on the possibility of introducing DTCA have been held in Canada since 1996. Although no new legislation has been introduced, important shifts in the interpretation of the law have occurred, contributing to an increasing volume of made-in-Canada advertising. In addition, Canadian exposure to prescription drug advertising in US media has grown enormously since 1997, when a shift in US regulatory policy facilitated the broadcast of such ads. The pharmaceutical industry spent more than $4 billion on DTCA in the US in 2004.

DTCA is prohibited under two provisions in Canada’s Food and Drugs Act, which is enforced by Health Canada. Despite this prohibition, Health Canada currently allows two forms of advertising:
  • Reminder ads: these include only the brand name and no health claims or hints about the product’s use. No risk information is required. In the US, reminder ads are prohibited for products with “black box” warnings of serious risks on their label.
  • Disease-oriented or help-seeking ads: these do not mention a specific brand but discuss a condition and suggest consumers ask their doctor about an unspecified treatment. No risk information is required.
In the US, the Food and Drug Administration (FDA) also recognizes a third type – full product ads. These are permitted to include the brand name and health claims and must by law include risk information.

In practice, the job of regulating pharmaceutical advertising in Canada has been largely delegated to three organizations: the Marketing Practices Review Committee of Rx&D, the research-based prescription drug pharmaceutical industry association; Advertising Standards Canada (ASC), an advertising industry association; and the Pharmaceutical Advertising Advisory Board (PAAB), a multi-stakeholder group. None of these groups is directly responsible for regulation of DTCA, as officially such advertising is illegal in Canada. Health Canada directly handles complaints about DTCA, including complaints sent to ASC or PAAB. However, there are no published guidelines for submission or handling of complaints about direct-to-consumer advertising.
CodeCHSPR 06:01R

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