New Study finds only 6% of drug advertising material is supported by
evidence
BMJ 2004;328:485 (28 February)
Only 6% of drug advertising material is supported by evidence
Heidelberg Annette Tuffs
A new study of the advertising material and marketing brochures sent out
by drug companies to GPs in Germany has shown that about 94% of the
information in them has no basis in scientific evidence.
The study, carried out by the Institute for Evidence-Based Medicine, a
private independent research institute in Cologne, evaluated 175 brochures
containing information on 520 drugs, which were either sent by post or
handed out to 43 GPs since last June. The study was published in this
month’s issue of the drugs bulletin Arznei Telegramm (2004;35:21-3;
www.di-em.de/data/at_2004_35_21.pdf ).
About 15% of the brochures did not contain any citations, while the
citations listed in another 22% could not be found. In the remaining 63%
the information was mostly correctly connected with the relevant research
articles but did not reflect their results. Only 6% of the brochures
contained statements that were scientifically supported by identifiable
literature.
The evaluation was done by two specially trained and independently acting
reviewers. In cases of doubt a third reviewer was involved.
"This is the first study in Germany evaluating the quality of drug
advertising material," says Thomas Kaiser, a scientist at the institute
who published the study together with Peter Sawicki and other colleagues.

He points out that the advertising material presents distorted images of
the drugs’ profiles. The article lists several examples of
misrepresentation: medical guidelines from scientific societies are
misquoted or changed, the side effects of drugs are minimised, groups of
patient are wrongly defined, study results are suppressed, treatment
effects are exaggerated, risks are manipulated, and effects of drugs were
drawn from animal studies.
The authors warn that such a high amount of misinformation puts patients’
health at risk. Studies from other countries have shown that doctors tend
to base their decisions on the information and advertising material sent
out by drug companies. Therefore, the authors conclude, an independent
institution should be established to monitor the content of such material.

The German drug industry has decided to tighten the rules in its self
regulatory code on relations between the industry and the medical
profession with regard to cooperation in clinical studies and attendance
at conferences that are funded by drug companies.
The German Association of Research Based Pharmaceutical Companies in
Berlin announced that its members have set up an independent tribunal in
Berlin. Members of the tribunal will be chosen by drug companies and
doctors’ and patients’ groups but will not be elected representatives of
those bodies. Like a court, the tribunal will be able to punish companies
that break the rules, imposing fines of up to €50 000 (£34 000; $63 000)
or, in the case of a second offence, up to €250 000. Anyone will be
allowed to notify the tribunal of possible offences.
The initiative was the industry’s reaction to the German government’s
threat to install an executive against corruption. Doctors’ associations
have also tightened their rules on corruption.
More information about the Institute for Evidence-Based Medicine can be
found on its website, www.di-em.de/z_index.htm