Tag Archives: DTCA

Online drug advertising & the regulatory challenge

Between the (minor!) bike accident , the kid’s birthday, and being out of town for a bit, blog posting has gone a bit by the wayside the past few weeks. However, something that’s been much on my mind lately, and which I’d like to discuss here, is drug advertising online.

I’ve written various posts before about DTCA – direct to consumer advertising of prescription drugs – which is legal in limited form in Canada, and in much greater form in the US. I think prescription drug promotion of all sorts is a big social justice issue, and that DTCA is a significant and oft-overlooked consumer health info issue that librarians should have on our radar. When we talk about the Pew research on online health info seeking, social media, and “e-patients,” we cannot forget that profit-motivated companies are as interested in our patients’ online information behaviour as we are, just for very different reasons.

The Canadian “freedom of expression” lawsuit on this matter has been indefinitely adjourned, but I’ve come to wonder if perhaps debating the merits and perils of television and magazine ads may be rather passé in light of the Internet’s growing centrality as an advertising medium. Maybe CanWest was not just throwing in the towel on a lawsuit that was destined for failure (b/c the FOE argument was pretty weak), but also strategically abandoning old media. Nah, actually, I think CanWest is still pretty wedded to old media, but the rest of us aren’t. And we are the target audience for DTCA.

Now, I know some people (lots of them) still watch TV on TV, even with all this digital conversion business. But will they in a decade? Not so sure. Hulu has been such a huge success in the US, spawning constant rushes of hordes of international viewers to one proxy setup after another in order to see the latest episode of their favourite shows. It’s only a matter of time before online TV is de rigueur in any region with decent bandwidth & reliable connectivity.

The unofficial rules for online drug advertising have, to this point, basically been an extension of the TV advertising regulations. It’s debatable whether this is appropriate or not. I’ll take on whether the Internet is more like TV or more like the telephone in a separate post (soon! I promise!), but I think we can all agree that it’s not *exactly* like TV.

Many online ads, for example, require some active selection on the part of the reader/viewer, and are not necessarily as time limited as TV ads (and thus able to provide fuller information). Typical online drug ads today appear as advertisements in the margins of a website, and attempt to entice the reader into clicking them to go to a website with fuller information on whatever the condition/drug may be.

In a somewhat impressive attempt to be proactive (?), the FDA (US drug regulator) held a couple days of public hearings last month on the topic of online drug advertising. The 5-page list of speakers (pdf) was heave on pharma and health tech investors, followed by representatives of online services both general and health-specific, ranging from Google to WebMD. So that pretty much covers the people who want to advertise, and those who want the money from said advertising. Of note, there were reps of specific social marketing units within pharmaceutical companies on the docket, so Pharma is well aware of the stakes here (e.g. Sanofi-Aventis has a rep, and then the Sanofi-Aventis social media working group had a rep as well). Unfortunately, I could pick out only a very few advocacy/public interest groups, such as the Consumers Union.

To backtrack a bit, this hearing didn’t come out of nowhere, although it was not terribly well publicized.Back in April, the FDA issued warnings to some 14 pharmaceutical companies over their “misleading” online advertising. At issue was failure to fully disclose risks, and these letters focused on search engine ads (aka “sponsored links” in some search engine displays).

November’s hearings, however, were broader in scope, touching on not just search engine advertising, but also ads on websites, and – perhaps most significantly – in social media. This is excellent news, as we know that social sites are an ideal location for what I called “embedded DTCA with a social environment created to reach vulnerable and isolated populations” in my post about the “patient support” site RareShare a year ago.

So what? Where is this going? What does the Internet mean for drug advertising and patient protection?
Well, there some very interesting threads to watch as this policy story unfolds:

  1. The Internet doesn’t do super well with national borders. If laws on DTCA are different in different countries, do they have to appear differently based on site host location? IP address of the end user? How? DTCA on television has taken advantage of lack of political will to enforce existing laws to broadcast US drug ads across the Canadian border. Will the Internet do any better? (Personally, I am doubtful.)
  2. The Internet, however, does allow for end-user participation on a scale unprecedented by other media. Some people have voiced optimism regarding the potential for commenting and annotation to temper, force transparency upon, and generally “culture jam” drug advertising. Google’s SideWiki has received a lot of attention in this regard, but it remains fairly unwieldy to use and market saturation is quite low.
  3. The whole net neutrality debate applies here, and the way this debate influences our view of the Internet will influence the way we feel about things like online advertising. Is the Internet a media for entertainment or communications? Is it a utility, which should be neutral and allow for participation from all, or is it a medium for consumption? We would feel quite different about picking up the phone and hearing an ad than we do about a commercial break from a TV show.
  4. Social media can really blur the line between non-profit advocacy and for-profit promotion in a nasty way. It’s one thing to regulate what can or must be said inside a little “ad” box in the margin of a website. It’s quite another to regulate embedded personalities within a social media site, who are planted there to promote certain products. I will be quite surprised if these hearings/this process even touches on this issue, but variations on hidden advertisements are a phenomenon that’s well-known in the blogging world, maybe less recognized in some other social media fora (Facebook, where everyone is supposedly using their “real name”?)


p.s. During composition of this post I cheked the CBC news online, and lo and behold there was an example of DTCA right on the site. So I snapped a screenshot, of course, to stick up here. This is an example of a currently-legal “disease awareness” ad for erectile dysfunction, from the Health News page of the cbc.ca:


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Filed under government, Health, Internet, net neutrality, privatization

Canadian DTCA Charter Challenge Indefinitely Adjourned…and a tree falls in the forest

The News

In the middle of financial turbulence, potential bankruptcy, and a storm of management changes, CanWest Global has decided to seek indefinite adjournment of their court case challenging Canadian restrictions on direct-to-consumer advertising (DTCA) of prescription drugs.  In summary, CanWest was alleging that the ban on certain types of DTCA was infringing on their freedom of expression, especially since they couldn’t make money off that type of ad while media across the border in the US could. The case was seen as a landmark case as it was a challenge to existing law under the Canadian Charter of Rights and Freedoms (a constitutional law case, for non-Canadians reading this), and thus would set new Canadian constitutional precedent.

The adjournment request came right at the 11th hour, since closing arguments were set to be heard June 15-19, which is to say, this past week. While CanWest can request to revive the case, it seems unlikely at this point, when the company is facing billions in debt and is working to secure major restructuring deals. It appears that CanWest may silently agree with opposing lawyer Stuart Shrybman, that the company should have pulled the plug on this “ill-conceived litigation” months ago,” and that the best option at this point is to avoid pouring more money into what is pretty much a lost cause.

So what? In short, this case has cost both CanWest and the government a lot of money since it was filed in December 2005. Current regulations on DTCA in Canada are not well enforced to begin with, and to my knowledge there’s not much indication that this is changing. However, by not opening the floodgates wider, we may be able to avoid even more expense and needless adverse side effects (such as Vioxx related deaths) that appear to be encouraged by DTCA.

Didn’t hear about this?  I’m not surprised. Somehow nobody else has either.

The News (not)  in the News

This story has been weirdly absent from the media.  And by media, I mean practically everybody.  When I heard about CanWest dropping this case, I immediately ran to my web browser and started searching for early news coverage…nothing.   A week later…still nothing in the mainstream news sources.

The medical journals? One article in the faithful CMAJ, which has offered ongoing coverage of this trial and whose parent organization, the Canadian Medical Assoiaition, has an official position statement opposing “Brand-specific direct-to-consumer advertisements, such as those permitted in the United States.”

Okay, well, I figured that perhaps this was an example of the failures of traditional media.  Maybe media companies aren’t nimble enough to catch this story in a timely manner; maybe the industry carries an inherent bias against reporting on what is essentially a failure (of the cut-your-losses type) of a fellow media behemoth.

The bloggers, though – the bloggers will have lots to say about this, right?  The bloggers are the new media, right?  Citizen journalism! Media democracy! They are us! We are on the ground, everywhere, reporting on the real issues in our spare time, without budgets to support travel expenses or copyediting, and hoping our cameras are not confiscated by the police and our tweets are not blocked.

So far I have found one lonely blog post about this, from the magazine marketing industry, which I’m sure has been watching CanWest’s case avidly, as a CanWest win would potentially open up a whole new world of direct-to-consumer drug ads, with accompanying revenue stream, for magazines as well as television channels. That post did link to one other blog, from a magazine marketing magazine.

But basically, this adjournment has been a tree falling in the forest.  Why?  Is it just tough to compete in the health news arena the week the WHO declares a pandemic? Perhaps, but the possibility of federal regulations on trans-fats  is getting press. Do we feel bad for CanWest, and not want to slag them more? I dunno, we seem to have an appetite for the details of the restructuring /fall of the Asper family empire. Is DTCA just a boring topic? Well, discussions of the topic can certainly be acronym-heavy, but there has been plenty of coverage in the media (even in CanWest outlets) about the recent Plos ONE article, “Twelve Years’ Experience with Direct-to-Consumer Advertising of Prescription Drugs in Canada: A Cautionary Tale.”

What’s the deal?  I don’t get it.

My government went to court against the largest media entity in the country, basically won, and no one is in the forest to hear the media giant fall!

For previous posts on direct-to-consumer advertising, see: dtca part 1, and part 2.

Disclosure: I work with authors in the PloS ONE article cited above, including on DTCA-related topics.

ETA – Apparently I (and Google) missed The Tyee’s Hook blog coverage of this on June 12. It’s here, if you’re interested.  Of note in this article is the statement, “a spokesperson for Canwest says the company did not ask for the adjournment and plans to continue the case in the fall” — which is entirely possible but not something I have seen/read elswehere. Anyone reading this have more info on CanWest’s official stance on this?

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Filed under government, Health, media democracy, privatization

DTCA 2.0 & RareShare

I know, I know, everything is “such and such 2.0” now, and it’s getting really old.  I agree!  However, this really is “2.0,” as direct-to-consumer advertising (DTCA) of pharmaceuticals has officially moved from being all “push” media into its own special social networking universe. Check it out:

The Toronto Star called my attention to the social networking website http://www.RareShare.org last week. The uncritical article by the “Faith and Ethics Reporter” acclaimed RareShare for creating online support for the “forgotten people” who have diseases so rare that there are no local face-to-face support groups.  Call me cynical, but I wish the article went a little heavier on the ethics and a little lighter on the faith in altruistic corporate goodwill.

The RareShare site is tight-lipped about its corporate sponsors. From publicly accessible information, we know that the 2 founders of the site are U.S. business guys with specialisations in high-growth tech and biotech and communications. We know one of the corporate partners behind the RareShare site is Nutra Pharma, currently testing a drug for the rare disease adrenomyeloneuropathy.  And we know that, in addition to “moderated” (by whom?) discussions in communities organized by disease, the site plans to have doctors (presumably those who are friendly with the corporate sponsors of the site?) holding online Q&A sessions with community members.

The Privacy Policy is a bit odd, in that it appears to have been written for another website. ?? They collect your email address and track your travels in order to improve their page, customize their content to you, etc. They’ll remove your name and phone # when they share your info with other companies. They use cookies, and record session info, “such as items that consumers add to their shopping cart”?  Shopping cart?  Huh?  If you give your telephone #, they’ll only use it to contact you regarding orders you have placed online? What kind of a website is this anyway?

It is perhaps worth noting that the RareShare defintion of “rare” is considerably broader than some other lists of rare diseases, including such conditions as gestational diabetes, which occurs in about 4% of pregnancies, according to the American Diabetes Association. According to the Canadian Organization for Rare Disorders, “A rare or “orphan” disease affects fewer than 1 in 2,000 people.”  While expectant mothers with gestational diabetes may legitimately feel the need for more support, they are hardly living with a rare disease.  The inclusion of such common ailmentsparticularly ones such as diabetes that are hotbeds of new pharmaceutical interest, and sometimes lead to ongoing monitoring and medication for the rest of one’s life – do raise a question of drug company profit motive.

It’s all not necessarily fishy, but it is a perfect setup for embedded DTCA with a social environment created to reach vulnerable and isolated populations. Sort of makes me want to lurk around and see what goes on once things get kicking in their forums…

…So I admit it: I did just that. Here’s my report. The site is so new that there’s not much there yet, so it’s a bit hard to assess where it’s going.  There were about 160 members as of when I peeked in, most of whom appear to be patients or family members of patients. These individuals post seeking help, advice, and connection with others.  Many of them are disclosing their personal stories: their ages, location, when they were diagnoses, what drugs they’ve already tried, etc. They join ”communities” of diseases based on their actual or suspected diagnoses.

Then, there are 2 members who appear to be doing far more posting then everyone else: one of the 2 site founders, and the CEO of a drug company.  The site founder has joined several communities and posted welcome messages in the forums.  The CEO has similarly joined many communities and in some he has posted messages such as:

“We’ve found that an already existing class of drugs is effective about half the time in XYZ syndrome. Please contact me for details of our Next Generation Disease Management service.”

“We think an already existing class of drugs may help in XYZ disease. Please contact me for details of our Phase IV trial.”

”We think already existing drugs may supplement standard chemotherapy and radiation treatment for XYZ cancer. Please contact me for details of our Phase IV trial.”

In addition to clinical trial recruitment, there is already some advertising for lab tests, for example Designer Diagnostics test kits of Nontuberculosis Mycobacteria (NTM).  Each disease community “home” has a link to more information about the disease.  Many of these pages are still pretty empty, but in the case of a few, this link leads to a full page that does not document the source of most of its information.  On the NTM disease information page, for example, under “diagnostic tests” there is only one brand of test mentioned.  If you follow the link to more information about the test, you can read about why this test is allegedly better than other tests, and you can follow another link right to the website of the manufacturer of the test.

Annnnnd, if you follow enough links on the Designer Diagnostics website, you can eventually get to the fact that they have a parent company.  This parent company, unsurprisingly, is the very same Nutra Pharma that you may recall is one of the corporate partners behind RareShare.

What a coincidence.

There is a clear and present need for more support and networking among patients and doctors dealing with rare diseases. If the public sector is not going to provide this type of health care, information and support, it is natural that the private sector will naturally seize the opportunity. We should not for a moment, however, forget that firms, unlike public health infrastructures, work from a place of their own bottom line and fiscal responsibility to their shareholders. For them to actually act out of total altruism and concern for the patients would be a conflict of interest.

– Greyson


Filed under Health, privacy, privatization, technology

DTCA, part II – Unpacking the Expressive Freedom argument

Part II of a likely-ongoing series of posts regarding Direct-to-Consumer Advertising of prescription drugs (DTCA), here is some discussion from a librarian’s standpoint regarding CanWest’s claim that Canada’s ban on DTCA infringes on the media company’s Charter-granted “Freedom of Expression.”

Freedom of corporate expression vs. human rights of people?

There is certainly a legitimate debate regarding whether the ability to sell ads is truly “free expression.” This case, after all, is not even looking at the question of pharmaceutical companies’ right to communicate their advertising content, but at CanWest’s right to make money off of this advertising content.

Canadian Supreme Court precedent is to interpret expression broadly, to include pretty much any attempt to convey meaning. The library community has generally supported this broad interpretation, even when applied to paid advertisements, as in the multiple challenges to the queer newspaper Xtra! West based on allegedly explicit advertising content (See BCLA’s “Censorship in British Columbia” timeline for details of some of these challenges)

I’m not 100% sold, personally, on the argument that paid ads in Media X are Media X’s own expression. However, if you do accept that CanWest has a charter-given right to freely express itself by way of selling ad space to ads that contain content that may be detrimental to Canadians’ health, then the second question we must ask is, of course, whether CanWest’s right to sell ads is in conflict with Canadians’ human rights (e.g., health). If so, does this right to free expression outweigh the negative impact on health as a human right.

Is there precedent?

There certainly is! And it swings in both directions. (Whee!)

The Supreme Course has upheld at least three similar restrictions on free expression:

Frankly, as a civil libertarian and advocate of intellectual freedom, I think the latter two of those three are bad decisions. But, saving that for another post on another day, there clearly is precedent for limiting free expression, even expression by corporate interests.

Tobacco and alcohol are the clearest analogues to prescription drugs, seeing as they are also regulated substances that have been allowed limited advertising. Unfortunately the stories are messy and neither is a perfect analogue. Prescription drugs, when used correctly, can actually improve health and save lives, which cannot be argued at all by tobacco which will eventually kill almost anyone (thus faces the strictest restrictions of the three classes of substances) and hardly by alcohol (which is allowed to advertise to adults in many media).

The Tobacco Example

The tobacco advertising history is especially complex, but – because of that complexity – may be instructive as we watch the DTCA case play out.

In 1995, the Supreme Court narrowly struck down the Tobacco Products Control Act that prohibited tobacco advertising. RJR-MacDonald argued in 1995 that the act infringed on their freedom of expression on under Sec 2(b) of the Charter, similar to what CanWest is arguing about the DTCA restrictions. The majority opinion of the court was that there were not grounds to invoke the limiting clause (Sec 1 of the Charter) in the case of tobacco advertising. The minority opinion was, of course, that there was cause to limit tobacco advertising, because the product is harmful and often fatal, and advertising targeted young people.

Of course, in 1997 a new tobacco ad regulation law was passed, the Tobacco Act, which limits, rather than completely prohibiting tobacco ads. (There has been speculation that the government’s inflexibility to considering anything but complete prohibition on advertising angered the court; this more moderate approach of regulation has seemed to succeed.)

How does that compare with the case of DTCA?

Prescription drugs can be harmful or fatal, but should not be when used properly. The advertising increasingly does target young people – and women, another “vulnerable” population according to previous court decisions such as Butler. But there are, in theory at least, professionals to mediate people’s access to the products.

The current prohibition on DTCA is not absolute, and in fact more closely resembles the latter Tobacco Act restrictions on promotion than the earlier absolute prohibition (although again it must be noted that enforcement of the restrictions is pretty toothless).

So it would seem to me (in my unequivocally not-a-lawyer mind) that the question is one of how tightly we need to regulate/limit DTCA. Which hinges on the question of how harmful it can be (i.e., how much “limiting” can we reasonably invoke upon this type of expression).

All of which more or less brings us to Vioxx…

Ah, yes, Vioxx (rofecoxib), perhaps the ENRON of pharmaceutical regulation?

According to the New York Times’ handy Vioxx timeline, the FDA approved Vioxx on May 20, 1999. In June 2000 the VIGOR study final data was submitted to the FDA. This was the study that showed a 4x higher rate of heart attacks among patients using Vioxx than those using naproxin (a NSAID, standard osteoarthritis pain treatment). On Sept. 28, 2004, more than 4 years later, the FDA met with Merck about the cardiovascular adverse effects and Merck agreed to “voluntarily” withdraw Vioxx.

The FDA estimates that between 1999 and 2003, Vioxx may have contributed to almost 28,000 heart attacks and sudden cardiac deaths. Some other estimates range much higher.

During that same time period, 1999-2004, Merck spent $550 million on DTCA for Vioxx to the US public. Vioxx was pulling in about $2.5 billion (yes, billion with a B) annually for Merck during this time.

It seems pretty clear that Vioxx was approved on limited safety data, yes, but that even after data showing harm was submitted it took years (and another still more damning study, APPROVe, in 2004) before action was taken to withdraw this drug from the market.

Years during which people sickened and died needlessly.

Years during which the drug which was sickening and killing them was being heavily promoted both to doctors and the public, to the tune of record ad spending *and* record profits.

How much less uptake might there have been of Vioxx without all the Direct-to-Consumer Advertising? It’s hard to say definitively.

Does this example of Vioxx, a product with huge DTCA and huge sales, demonstrate enough risk or harm inherent in DTCA to justify limiting this type of expression?

To be continued…


See here for DTCA part I – the CanWest legal challenge


Filed under Health, Intellectual freedom

DTCA, part I – The CanWest Legal Challenge

This is the first of what I’m sure will end up being several posts on Direct-to-Consumer Advertising of prescription drugs. It’s an issue I never thought too much about as it silently crept into our magazines and televisions in the US, but once living in Canada and working in health policy, my eyes were opened to what a weird and complex issue this truly is. As a librarian, I was trained in the protection of freedom of expression, and as an agent of public health I have the responsibility to prioritize the health and welfare of the population. It is fascinating for me to explore an issue where suddenly all the great health policy thinkers I respect are arguing *for* government regulation of expression and it’s the giant multinational multi-$$$ conglomerate-corporations who are crying out that their expressive freedom is being infringed upon.

Background on DTCA:

Direct-to-consumer advertising (DTCA) of prescription drugs is only considered to be legal in two countries: the US and NZ (and NZ came very close to banning it last year). Neither country voted in a law to legalize DTCA or had any public consultation or parliamentary debate leading to the legalization. In the US, notably, the FDA relaxed its guidance on drug advertising in 1997, following drug companies’ pushing the boundaries farther and farther with little to no enforcement of the then-existing rules. The pharmaceutical industry has aggressively lobbied to be permitted to advertise prescription drugs to consumers in other regions, as TV drug advertising has proven to have a stunning return-on-investment for them. In 2002, the EU parliament actually voted on legalizing DTCA – 498 against to 42 for legalization.

Canada currently allows only very restricted forms of DTCA– although the rules are rarely enforced and often rather blatantly flouted (e.g. an illegal drug ad on the wall in a hospital near my house last year!). As I have alluded to previously, illegal print ads in public places abound this year as well. Additionally, Canadians are to some extent “contaminated” (to speak epidemiologically) by drug ads which US television stations (illegally) broadcast across the border. The existing systematic review of Benefits and Harms of Direct to Consumer Advertising finds that DTCA works – which is to say it affects prescriptions, sells the product it advertises – but that there is no evidence of any health benefit to the practice.

In a free-market health care “system” such as the US, this may seem a neutral, or even positive, finding when considered as innovative capitalistic market success. However, in a country such as Canada, which has the premise of universal healthcare as a human right as an element of its national identity, needless costs on health care are seen as coming out of the taxpayer’s pocket and thus diverting resources from other potential government/health services. (This is not to imply that the US should not consider cost of pharmaceuticals, particularly in light of the new Medicare Plan D for seniors, but just to clarify why the practice of DTCA may be framed differently in the different political economies.)

The Legal Challenge:

CanWest MediaWorks Inc., a wholly-owned subsidiary of CanWest Global Communications Corp.,an international media company and the largest media owner in Canada), has applied to the Ontario Superior Court to strike down the current Canadian laws restricting DTCA. The basis for this application is the claim that the regulations violate Section 2(b) of the Canadian Charter of Rights and Freedoms.

For non-Canadians, the Charter is the bill of rights in our constitution. It was only formally enacted in 1982, so the legacy of case law is rather young, and lots of things are still being defined and duked out in court. (As someone who grew up in the US and recalls celebrating the bicentennial of that constitution in grade 5, this is fascinating to me!)

One of the interesting things about the Charter is the very first section, which is called the “Limiting Clause” and more or less says that all of the rights about to be laid out in all the sections that follow can be limited if the limitations can be justified in a “free and democratic society.” The next section after this limiting clause that makes all other clauses non-absolute is the one that includes “Fundamental Freedoms” such as freedom of expression (the aforementioned 2b), thought, press, peaceful assembly, etc. The interplay between these first two sections leads to all sorts of fascinating legal wrangling – an example of which that is near & (not so) dear to many librarians is the Butler obscenity case, which set precedent for limiting pornographic free expression.

Finally, it should be noted that way down in Section 26, the Charter states that there may be other rights and freedoms, and that the rights & freedoms spelled out in the Charter should not infringe on those other rights. Some legal scholars have argued that health care falls under these other rights, while others think health is actually covered under another section (7) that guarantees “life, liberty and security of person.” Suffice to say here that there are sections under which health care could be argued to fall, and thus could possibly justify limiting freedom of expression. It’s all pretty convoluted, eh? Because free expression is protected under the Charter, in Section 2, it takes a very strong concern to enact Section 1’s Limiting Clause and limit any forms of expression. Ads are a form of expression (at least on the part of the content creator), so the question here becomes:

Are the harms of DTCA strong enough to justify (in a free and democratic society) limiting free expression?

In order to truly answer this question, there are a few issues to tackle:

  1. What are the harms of DTCA?
  2. How dangerous to freedom and democracy does it seem to limit the “expression” of DTCA?
  3. Are there other rights & freedoms not specified in the charter (such as a right to health/health care) that could justify limiting Sec 2 in the case of DTCA?

Next installment: unpacking the Freedom of Expression argument here


Filed under Health, privatization

CHN Part II – Replacement Resources?

What resources will fill in for the CHN when it no longer exists?

Let’s consider our options…

  • The US NIH, via MedlinePlus (not Canadian, necessarily US-biased…which makes little difference in some areas and a whole lot in others, like pharmaceuticals)
  • Provincial Health Portals/Guides (Typically not in-depth and underutilised)
  • There is that new Canadian government consumer health website, Healthy Canadians (unfortunately, it only covers the 6 topics the current government wants you to be thinking about)
  • Hospital or Clinic websites (How many of these are still non-profit and impartial, particularly if they are US institutions?)
  • For-profit medical websites such as WebMD and WrongDiagnosis.com (Supported by advertising…need I say more?)

The CHN is big, well-used, and non-commercial. These are non-trivial attributes in an information source.

Interestingly, at the same time as the primary, premier source for Canadian consumer health information is being defunded, another source of health “information” is proliferating – one that I wager will ultimately cost Canadians far more than the piddly price of a few librarians, nurses, and IT folk who appear to make the CHN happen. This flourishing source is, of course, pharmaceutical industry advertisements.

Is it merely coincidence that there are more public “reminder ads” (the kind that are legal here in Canada – you can get away with much more in this arena in the USA and NZ) around my city this fall than I’ve seen since moving here? Bus shelters encourage us to have warm fuzzies about Celebrex (a Vioxx-like drug), subway ads ask us if we’ve had a HPV vaccine, among others.

There is currently a battle going on in this country over how far drug advertising should be allowed to go, and the pro-ad argument tends to fall back upon the unproven notion that pharmaceutical advertising is somehow educational to patients in a way that can improve health outcomes, not just teach then to ask for drugs. While I like a good conspiracy theory as much as the next lefty, I’m not suggesting that the rise in drug advertising has been deviously crafted to fill the void we will feel when we no longer have a national health website on which to look up arthritis or human papilloma virus. I am however, quite concerned over the trend here.

When a pro-privatization government cuts national funding to social infrastructure and, at the same time, turns a blind (or at least feeble) eye to corporate challenges to public health and social policy regulations…well, I guess that’s where all that information literacy training we librarians are always pushing comes in. Because health information with a profit-motive is clearly not in the public interest. But without a not-for-profit health education, will we recognize it when we see it?

Resource list inspired by:
Evans, M. (2007, November 13). Searching for sound medial advice online. Globe and Mail. Retrieved November 19, 2007 from: http://www.theglobeandmail.com/servlet/story/RTGAM.20071113.wevans13/BNStory/specialScienceandHealth/home.



Filed under Health