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<text id=91TT1557>
<title>
July 15, 1991: The FDA's Next Target:Drugs
</title>
<history>
TIME--The Weekly Newsmagazine--1991
July 15, 1991 Misleading Labels
</history>
<article>
<source>Time Magazine</source>
<hdr>
HEALTH, Page 56
COVER STORIES
The FDA's Next Target: Drugs
</hdr><body>
<p> The report, aired on a local news program in Detroit this
spring, trumpeted the success of the drug Xanax in treating
panic attacks. Former Houston Oiler Earl Campbell appeared in
the segment and poignantly described his battle with the
psychiatric disorder. A useful little news spot? Actually, it
was more of a commercial. Upjohn, which manufactures Xanax,
produced the video segment, paid Campbell for his performance
and sent the tape ready-made to TV stations around the U.S. as
part of a campaign to peddle its product.
</p>
<p> Traditionally, ads for prescription drugs were pitched
only to doctors, primarily in medical journals. But as
competition for market share intensifies, more drugmakers are
doing as Upjohn did, crossing the once inviolable line and
appealing directly to patients. This high-powered approach,
combined with some questionable marketing practices, has
provoked the ire of FDA chief David Kessler. "Promotional
practices, to be blunt, have got out of hand," he recently told
drug-industry lobbyists.
</p>
<p> To underscore the pitfalls of direct-to-consumer
advertising, Kessler points to an ad for Actigall, a medication
for gallstones. The ad, which ran in newspapers and magazines
around the U.S., suggests that the Ciba-Geigy product is a good
alternative to surgery. Kessler objects because surgery is the
preferred treatment in most cases. Though many people find the
drug ads helpful, doctors share Kessler's concern. "The consumer
can take a little bit of information and come to the exact
opposite conclusion that he should," says the American Medical
Association's Dr. M. Roy Schwarz.
</p>
<p> Physicians are leerier about another of Kessler's
campaigns: restricting the promotion of drugs for purposes other
than those explicitly approved by the FDA. Such "off-label"
prescribing is surprisingly common in the U.S. About one-quarter
of the 1.6 billion prescriptions written each year are for
unapproved purposes. In the mid-1980s some drug-company
salespeople began encouraging such uses, a practice Kessler
views as dangerous.
</p>
<p> In one regrettable example, drugs called calcium channel
blockers were touted as a treatment for heart attacks, though
they had been approved only for hypertension and angina. Later,
researchers found that some heart-attack patients faced an
increased death risk after taking the drug.
</p>
<p> To counter promotional abuses, Kessler is doubling his
advertising-enforcement staff and plans to release stricter
drug-marketing guidelines by year's end. But doctors fear that
a clampdown could actually impede the flow of medical
information. Cancer specialists in particular rely on drug
companies to help inform them about experimental uses of drugs.
"The reality is that this is the way oncologists get educated,"
says Dr. Robert Young, director of the Fox Chase Cancer Center.
"If you start denying that information to doctors, then people
are going to die."
</p>
<p> Clearly, the pharmaceutical industry is suffering from a
bad case of hucksterism. But policing the complex world of drug
promotion will be a tougher job for the FDA than wiping the
FRESH label off a carton of orange juice.
</p>
<p> By Andrew Purvis. With reporting by Anne E. West/Washington
</p>
</body></article>
</text>