A US government report released on Dec 4 found that drug companies promote misleading advertisements for their products, even after the Food and Drug Administration (FDA) has tried to halt them.  Further, the report notes that drug companies have continued to make misleading claims even after being cited, in some cases repeatedly, for violations.  <snip>.  The result is that enforcement is being delayed by 2 to 11 weeks.  With the life of many advertisement campaigns less than 2 months, the misleading information may have been completely disseminated before the manufacturer receives the FDA letter.....

From the March/April 1997 issue of FAIR's magazine, Extra!--

The Media and the Menopause Industry:
Advertising has muted dangers of estrogen therapy
By Barbara Seaman

You don't get product ads unless you praise the product.
--Gloria Steinem, founding editor of Ms.

In his book Adverse Reactions, Thomas Maeder recalls the philosophy of Harry Loynd, an old-time president of Parke-Davis who was legendarily blunt.
Loynd's oft-repeated motto was "Pills are to sell, not to take." He regarded physicians as extremely gullible, and lectured his staff, "If we put horse
manure in a capsule we could sell it to 95 percent of these doctors."............................
<major snip>

In 1975, Abe Rosenthal, then executive editor at the New York Times, offered me a job writing about consumer affairs and health, starting at scale. I was
aware that he had just hired Mimi Sheraton to write about food for twice that amount. So, as a veteran author of several magazine columns and two
books, I asked him to justify the discrepancy, pointing out: "Her job is fun; mine would be hard work." He replied, "Yes, but she would bring in ads,
and you will lose them."

 Placement of 3/4 page glossy ad copy with FDA warning on -preceding- 1/4 page.

        Wyeth-Ayerst, the makers of Premarin and Prempro took out a full page ad touting their products. Except oddity number one is that the required FDA product warning text was found on the preceding 1/4 page and the glossy image ad with narrative text was found on the following 3/4 page. Now why didn't they spread the whole thing out on a single full page? They paid for a full page ad. Why didn't they use it? Was this an inadvertent or an intentionally deceptive choice?  The W/A ad placement required breaking up the text in an awkward manner of another article so this could not have been an editorial choice. Could it be that W/A did not want the reader to make the connection between the ad text and the FDA warning?

        Usually, (and equally deceptively) the required FDA product warnings follow the drug ads, but this time the FDA warning preceded the ad making it unread and unrelated without even a title heading, taking advantage of the typical reader response which is to read forward and not backwards to avoid making an obvious connection to the accompanying glossy photo ad. 

        Being careful to read all such drug ads word for word, it was not until the very bottom of the two pages of laudatory text for Premarin that this line was found: "Please be sure to read the important information preceding this ad".  I had to scratch my head a bit to figure out what they were saying and what they meant by "preceding information." When I turned the page backwards, there was the UNTITLED small print warning undoing pretty much of what the glossy ad tried to accomplish with appealing photos and soothing ad copy. 

        Caveat Emptor.

Joan L.

More at Premarin Ad Critique    (Detailed critique of the ad's visuals, major level text,   2nd level text , osteoporosis info, body text and synopsis)

Editorial - The Ethics of the Medical Internet
from Medscape General Medicine [TM]

                       Medscape Advertising Policy

                       Most medical and health information/education sites on the World WideWeb, like their counterparts in print publishing, rely on advertising,
                       including banner advertising, grants, and sponsorship of Continuing Education programs. In order to ensure editorial integrity, Medscape has
                       established the following principles governing the acceptance and displayof advertising on the Medscape site:

then lists 12 principles it will follow which overall should eliminate the problems outlined in the first URL above. I do not know if Medscape actually follows these principles as I haven't specifically looked, but at least it has them and I recommend reading them. They form a good check list to have in mind while reading sleazier sites or print materials.

DDMAC has reviewed this disseminated advertisement and has determined that it is in violation of the Federal Food, Drug, and Cosmetic Act and its implementing regulations. Specifically, we object for the following reasons:

 Overstatement of Benefit
 The advertisement is misleading because it mischaracterizes the nature of osteoporosis, resulting in an overstatement of X's benefits.

 For example, claims such as “A disease of thin, weak bones that can fracture and take away your independence” and “Don’t let osteoporosis stop you” misleadingly imply that having osteoporosis is, in itself, debilitating. However, while osteoporosis increases the risk of fracture, not every osteoporotic patient will suffer a fracture. In addition, those who do will not necessarily suffer any loss of independence because many osteoporotic fractures are asymptomatic. Furthermore, while X may reduce the risk of fracture, it does not eliminate it altogether therefore these claims misleadinglv imply outcomes and guarantees of efficacy for X that have not been demonstrated by substantial evidence.