DRUG companies have been told to stop running 'educational' advertisements because they are anything but educational.

The Health Sciences Authority (HSA), Singapore's medicines regulator, is concerned about the increasingly 'creative' slant drug companies are taking. It told The Straits Times that these educational campaigns were thinly veiled advertisements, which are banned here.

It plans to re-look the issue with the industry. It wants stricter rules to ensure that drug companies do not cross the line, using campaigns to push their products.

Like most countries, Singapore does not allow direct-to-consumer advertisements for prescription drugs. It prefers to let doctors tell patients about medicines.

When the HSA agreed four years ago to allow drug companies to run educational campaigns, the understanding was that they would provide objective and unbiased information about a disease.

This would encompass alternative treatments, including the benefits of diet and exercise.

Instead, some advertisements rely on scare tactics and give little information. Some promote new and innovative products that lack long-term safety data, said HSA deputy director Madam C. Suwarin.

She said some drug companies were also becoming 'too creative', such as paying for coverage in newspapers, magazines and on the radio.

A few years ago, the HSA chided Merck, Sharpe & Dohme (MSD) for its bus stop ads. MSD promptly removed them.

MSD marketing director David Peacock said his company had no intention of breaching the rules and all the campaigns that the company has run since then had complied with the regulations.

He felt that there was a role for educational campaigns, especially when many are unaware that they have a disease.

Dr Kevin Tan, vice-president of the Diabetic Society of Singapore, agreed that a review might be timely. But he also felt that campaigns by drug companies had helped patients and he 'would not like to see this end'.

Educational efforts by the Government were not enough and 'coverage would just not be as intense without the help and drive of pharmaceutical companies', he said.

Dr Beh Suan Tiong, president of the Obstetrics & Gynaecology Society of Singapore, also supported industry education. He said: 'They are important components in any disease management and prevention, be it by public or private organisations. Both have their roles.'

Madam Suwarin said the HSA also thought it good for the industry to help patients. She said: 'We know we need to work with others. We want to be a smart regulator, carrying a small stick, like a conductor building a symphony. Not a big stick to hit them with.'

But it must also make sure that drug companies do not push patients into demanding medicines that they do not need.

She said that the focus on depression in the United States has sent the number of prescriptions for anti-depressants soaring. Such medication is meant only for severe depression, but doctors dole it out freely.

The drugs can have severe side effects, including suicidal thoughts in youth.The HSA does not want to see it happen here.

salma@sph.com.sg

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POINTS MADE ABOUT CANCER AD

THE Health Sciences Authority (HSA) says this advertisement does not qualify as an educational campaign because:

- It does not list the symptoms of cervical cancer.

- It does not mention risk factors associated with the disease, such as smoking or sex with a partner infected with the human papilloma virus.

- It does not tell women about the importance of pap smears, which are the only way to detect the cancer early.I

- It plays on emotions, and uses fear as a tactic.

- While it does not tout a vaccine against cervical cancer, it said: 'Cervical cancer can be prevented. Find out more about how you can protect yourself from the virus that causes cervical cancer.'

Madam C. Suwarin, a deputy director at the HSA, said: 'A disease-awareness campaign should be less creative and have more factual content.'

GlaxoSmithKline, the company behind the ad, refutes those claims. It said:

- It prints leaflets with 'comprehensive details on cervical cancer and the preventive option of pap smear screening'.

- Patients can get these from clinics.

- The figure it used - one woman dies of cervical cancer every five days - is from the Health Promotion Board.

- The ad uses facts, not fear.

- Its message is: There are too many avoidable deaths. 'This is a balanced, neutral approach.'

This story was first published in The Straits Times on May 5, 2008.