In a recent article in the Financial Times (January 10) [read it here] scholars Alberto Mingardi and Jacob Arfwedson call for a lift of the EU ban on advertising for pharmaceuticals, because restricting such advertising represents a health hazard. As Mingardi and Arfwedson write “Patients want more information.” The ageing population in Europe and their increasingly higher standards of living has led people to be more concerned about their health – and to do something about it. As a result of patients’ concern there is a growing demand for information, which is supplied in the form of television programmes, books, magazines and websites focusing on health. This increase in information relates to basically every area, except when it comes to prescription drugs. Why? Because a 1992 European Union directive bans this form of advertising, thereby restricting consumer access to information.

In some of the EU member states regulation is even stricter than the directive requires. In France any information supplied directly to the public by manufacturers is considered to be advertising. Italy bans the advertising of prescribed medicines. Hence, health consumers depend predominantly on their family doctors for information concerning new therapies and products. The Danish health consumers are in a similar situation. In the Danish public health care system the average patient at a consultation spends less than 10 minutes with his general practitioner, hardly enough time to hear about various treatment options.

As Mingardi and Arfwedson point out it is generally agreed that freedom of information benefits consumers. However, European regulators consider pharmaceutical advertising too dangerous to be handled by the public. People are apparently not smart enough to be informed. Surveys in various EU countries (for instance the Populus/Stockholm Network survey of 2004) all show that patients want more influence over their treatment and drugs. European patients care deeply about equality of access, but they are also increasingly consumer oriented when it comes to treatment, and all of Europe’s healthcare systems are ill-equipped to handle the consumer approach to services, because so far the systems have been managed through waiting lists and the shifting priorities of political expediency.

However, not only the patient/health consumer is putting pressure on the system. Recent European Court of Justice rulings have stated that EU member states must reimburse patients for treatment in other countries if their national health service is unable to meet demand. Management through waiting lists is not compatible with patients being able to go to other countries for treatment.

Companies create products because they believe (for whatever reason) that there is a demand for them, but in order for consumers to be interested in any product they must first be aware that the product that can solve their problems is available. That is the reason why entrepreneurs and companies invest in communication and marketing.

Companies advertise so as to alert consumers to their products, but at the same time they perform a valuable service to the general public by providing information. If companies did not do this the cost (in time or money) of getting the information would be much, much higher. For instance every weekend I get bombarded with flyers from the local grocery stores, some of which I very rarely frequent (they are not on the way home, so why bother going there to see if they have good offers). However, through the flyers delivered to my door my wife and I can at our pace go through all of the flyers and decide what to get – and from what stores. And sometimes the flyer from the store we never go to contains a good offer, which makes us go to get our groceries there and save 100 euros on groceries that week.

Companies, economists and entrepreneurs are all well aware that information is an essential factor of production and of a free market – but apparently not many regulators know this. Mingardi and Arfwedson correctly observe that when it comes to prescription drugs, many objections (most, if not all of them erroneous) are raised:

•     “A common claim is that: “Drugs are not like other products.” In fact, drugs are exactly like any other product to the extent that they are produced in order to fulfil a need.

•     It is also said that “drugs are dangerous.” True, but so are any number of products that are handled without proper information and advice. Automobiles are highly dangerous and expensive. Hence, purchasing a new car involves consumer cost-benefit analysis, including of safety features. Indeed, this is literally an issue of life and death. Advertising is one important source of information among others, but that does not mean consumers will buy a new car only because they have seen an advertisement.

•     Another objection is that “advertising downplays safety.” In justification of strict government regulations, producers are regularly accused of stressing the benefits and minimising the risks associated with their products. But an important difference is that companies suffer immediate sanctions through financial loss if they neglect their consumers, unlike bureaucrats whose income does not depend directly on their services. In addition, this view assumes that companies are the sole providers of information, whereas pluralism demands a much wider array of suppliers. The fact that publishers rely on advertising does not imply that books are getting positive reviews.

The core issue is the free and unrestricted access to information, commercial or otherwise, for the benefit of consumers and citizens as sovereign decision-makers. Advertising practices for prescription drugs, where authorised, certainly leave room for improvement. This is more a question of reviewing regulations to make more information available to healthcare consumers than of tightening restrictions. In this context, the EU ban on advertising is a big obstacle to the quest for more and better information on medicines. The EU ban on advertising may very well be harmful to European health consumers. It may even cost lives.