Tv Ads Shove Drugs Down Our Throats

Sydney Morning Herald

Saturday October 7, 2006

Ruth Pollard

A weight-loss medication has won the right to be named on TV, writes Ruth Pollard.

WE HAVE pills to get rid of headaches, pills to get to sleep, pills to get it up, pills to get over depression and now pills to get rid of excess weight.

Under the guise of "consumers taking control of their health", the vast and growing self-medication industry - involving pharmacies, complementary therapies and over-the-counter drugs - is pushing people toward a life where they chose which drug to take for whatever ailment they have self-diagnosed.

The problem: they are not experienced clinicians, and conditions written off as trivial may indeed be serious. Drugs considered helpful could have serious side effects or interact badly with other medications.

The margin for error is enormous, and without careful consideration, lives will be at risk.

A new element has just been added to the mix.

Australians, previously protected from direct-to-consumer advertising of most medications, are now being exposed to ads pushing the anti-obesity drug Xenical, which was recently reclassified to allow the drug company to bypass doctors and target potential patients.

The next pill up for reclassification is the migraine drug sumatriptan, which is made by GlaxoSmithKline.

It is only available on prescription but next week the National Drugs and Poisons Schedule Committee will consider the drug company's second application to have the product rescheduled as an over-the-counter medication.

It is a potent vasoconstrictor that helps to constrict blood vessels that become enlarged during a migraine - yet people with heart disease or high blood pressure may experience serious side effects from the drug, particularly if those conditions are undiagnosed.

Naming a drug on television has a powerful effect - a pharmacists' email list has lit up in the past two weeks with examples of people of normal weight trying to access the anti-obesity drug.

Xenical, according to the guidelines, should only be given to people with a body mass index of over 30, or over 27 if they have other conditions, such as heart disease or high blood pressure.

It works by preventing the body absorbing fat. The downside? That means a person literally expels that fat, often in the form of oily diarrhoea. Many find the side effects intolerable.

"The incidence of almost stick-thin overseas tourists ... asking for Xenical by name has rocketed," one pharmacist wrote.

Still another commented that pharmacists will spend "a lot of time sorting out the few people for whom Xenical might be useful from the many who decide they want it, following promotion direct to consumer".

The deputy chairman of the Greater Metropolitan Clinical Taskforce, John Dwyer, said the move toward consumers taking more control of their health must be accompanied by a shift in the way health care is delivered.

"The concept of people taking more responsibility for their own health is important, but to do that they need to be educated ... especially when you are talking about complicated issues such as weight loss, migraine headaches or depression " he said.

The Australian Self-Medication Industry represents pharmaceutical companies, complementary medicine distributors, pharmacies and other health-care organisations.

Last year it launched its agenda: "Self-care is a personal choice; it is the extent to which an individual, family or community engages in any activity with the intention of improving or maintaining health, preventing disease, managing conditions, and restoring health."

Its scientific director, Deon Schoombie, said self-care was not just about medication, but also lifestyle management.

"When it comes to medication, when it is needed and necessary, there should be appropriate levels of access," Dr Schoombie said.

So how does one work out whether medication is needed in the world of self-care?

"It may be necessary for certain conditions to be diagnosed first by a GP or specialist ... but then further care can be provided by a pharmacist, for example."

A health economist, Paul Gross, believes that higher levels of self-care could provide cost relief for governments providing health care to an ageing population.

He said studies in Europe showed that switching 5 to 10 per cent of prescription medicines to over-the-counter status had reduced the use of doctors and cut total payments from government.

The problem lay in the lack of information available to health consumers and of an organised way of monitoring people's health, said Mr Gross, the director of the Institute of Health Economics and Technology Assessment.

"At the moment, I cannot get this information from my health fund, from Medicare or my doctor - I cannot get the information I need for consumer-directed health care."

© 2006 Sydney Morning Herald

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