IN Russia, drug advertisements that omit essential information and so could mislead consumers are illegal. However a recent study¹ examining pharmaceutical advertisements in medical journals for their adequacy of information has revealed that the law is frequently broken.

The study used a sample of five major Russian medical journals covering different fields of medicine and different types of publications, and evaluated all advertisements in all issues of the selected journals for 1998. Researchers counted the number of appearances of brand, chemical, and generic names; indication and contraindication; pharmacological group; safety warnings; and references. There were 397 placements of 207 distinct advertisements. Only 154 placements (40%) mentioned the generic name, 177 (45%) mentioned any indication, 42 (11%) mentioned safety warnings and contraindications, 21 (5%) warned about drug interactions, and just 8 (2%) provided references. The six companies responsible for the most advertisements on average provided less information than the other companies.

Reviewing these results the authors stress that the need for effective control over promotion is universal. Studies in Western Europe and North America have shown that even where objective sources of prescribing information are relatively easy to obtain, physicians are still vulnerable to messages in promotional material. In countries like Russia, where access to scientifically-based information is severely limited, even in university and hospital libraries, the situation is even more dangerous, they say. Even the voluntary standards of the WHO criteria for ethical pharmaceutical promotion and the International Pharmaceutical Manufacturers Association code of pharmaceutical marketing practices are rarely achieved in Russia. And multinational companies' internal guidelines are often not put into effect in the country. The Russian Pharmaceutical Association has a code of ethics, but this has no provisions governing the content of drug advertisements.

Effective regulatory systems imperative

The study concludes that few of the drug advertisements published in Russia provide the basic information required for appropriate prescribing and that pharmaceutical companies will not provide the information required for the appropriate use of their products unless forced to do so. The authors argue that clearly laws alone are insufficient. Effective regulatory systems are needed. They accuse some companies of appearing to be exploiting Russia's lack of defences for short-term gain at the expense of health care in the country.

Reference

1. Vlassov V, Mansfield P, Lexchin J, Vlassova A. Do drug advertisements in Russian medical journals provide essential information for safe prescribing? West J Med 2001;174:391 - 394.