The Age of Social Media and Marketing - For Sale: Drugs & Devices for Incontinence
In November, the Federal Drug Administration (FDA) called a hearing to discuss issues pertaining to disclosure rules for drug manufacturers on the Internet. In 2008, the pharmaceutical industry spent $4.4 billion on television and in print magazines combined, but just over three percent of this amount was spent on Internet advertising. Industry is eager to expand use of the Web to advertise its branded prescription drugs, in hopes of driving still more consumers to their doctors with symptoms and thus demands for advertised medications. A looming obstacle lies in the lack of FDA guidance about how to apply existing drug-marketing rules to new-age media and marketing. At the urging of Pfizer and others, the FDA agreed to host the hearing to air views both from patient safety groups, industry, and policymakers.
The FDA has long established strict rules for drug advertising requiring disclosures about the advertised condition and potential side effects from the promoted drug. The federal agency says that certain aspects of online marketing such as social media are not sufficiently covered by existing regulations and thus could warrant additional guidance. The problem is: Just what is missing and what additional regulations are needed? Are links enough for the manufacturer, when vast numbers of individuals are sharing information by forwarding messages on Twitter, Facebook and LinkedIn? How can this all be monitored or best controlled efficiently and effectively by the government?
Or should it be? A more fundamental question is whether control and surveillance are appropriate and within the realm of U. S. Constitutional freedoms? Consumer safety watchdog groups caution that links are not only insufficient, they are downright dangerous. They maintain that post-market surveillance, already inadequate on the FDA’s part, will become impossible. Meanwhile, an even more difficult question is whether pharmaceutical brand teams should be held responsible for consumer-created content on YouTube and other electronic social communication sites, for false information about their products.
Plenty of companies are already looking the other way, pushing the envelope with unofficial, satellite sites that are brand-specific, yet separate from the corporate "mother" sites altogether. Companies are funding totally unbranded sites intended to draw attention to the condition, in hopes of driving consumers to search for solutions in the form of prescription drugs and even surgical devices. Patient advocacy organizations are hardly innocent bystanders, selling out pages or even sections of their proprietary site to companies with branded or exclusive but still non-branded messages about a condition and a remedy. The wording and thus the messaging are often crafted entirely by the sponsoring companies.
Where does the Cirque du Soleil end? Do European countries have the right equation, by barring all commercial advertising and promotion of drugs, keeping costs lower so drug prices are far less than they are in the U. S.? Has our American economy, so dependent for decades on fueling demand for all consumer products and services by granting freedom of press without restriction, lost its control over healthcare costs as well as patient safety as a result of uncontrolled branded marketing?
In the end, the answer lies in public health education and elevating the health literacy of our citizens. For it is only in being an informed and watchful consumer that one can know the questions to ask of doctors and nurses, the information to gather prior to being diagnosed or treated, and how open to leave oneself to claims made in the advertising messages. Who are our nation’s healthcare educators? You, our readers, our healthcare professionals, and our providers. Not a friend’s Twitter, not a forwarded YouTube video, not a faceless blog. All of us healthcare professionals, those of us serving as public educators and patient advocates and those serving as healthcare providers of diagnosis, treatment, and care, are responsible for educating the public.
The age of the Internet has augmented, not shrunk, the scope of our individual responsibility to our patients and to the public at large. It has rendered more complexity, not greater simplicity, in how we respond and what we must initiate each and every day in our communications with others, whether they are face to face, by telephone, by e-mail, by Web sites, or by video and television. It’s a challenge we must accept, hand in glove with our fundamental rights and freedoms as U. S. citizens.
