AMA To Commission Study on Direct-To-Consumer Drug Ads

American Medical Association delegates at the organization's annual meeting in Chicago on Tuesday voted not to support limits on direct-to-consumer prescription drug advertisements until further study has been conducted, the AP/Las Vegas Sun reports (Tanner, AP/Las Vegas Sun, 6/22). On Sunday, AMA discussed whether to support proposed federal legislation that would impose a moratorium to delay DTC drug advertising after drugs are approved by FDA. Several state and national medical groups within AMA -- which represents about 250,000 physicians -- support some form of a moratorium.

Doctors who testified Sunday said DTC advertising by drug companies increases the number of prescriptions for potentially harmful drugs for people who do not need them. Most doctors testified in favor of a moratorium on DTC advertising that would allow doctors several months after a drug's approval to discuss its safety and efficacy with patients (California Healthline, 6/21). Following the advice of a committee that warned of potential First Amendment rights violations, the group agreed that further study is needed (Tanner, AP/Las Vegas Sun, 6/21).

Daniel Jaffe, executive vice president of the Association of National Advertisers, said, "Somewhere between 24 [million] and 30 million people have gone to their doctor to talk about a health problem they had never discussed before after seeing a prescription drug ad" (Saul, New York Times, 6/22).

DTC advertising "only strengthens the pressure doctors feel to give people what they want, even if it is not clearly what they need," a Salt Lake Tribune editorial states. "A bit of a physician-heal-thyself approach, increasing doctors' resistance to such entreaties, would help," but a "total ban on advertising drugs is probably overkill," the editorial continues.

According to the editorial, "Toning down the magic-pill ads considerably, allowing them only after a drug has been in widespread use for, say, a year, would help everyone. If the industry doesn't do that on its own, the doctors should issue a new prescription" (Salt Lake Tribune, 6/21).

AMA also addressed the following issues at the group's meeting:

• Antidepressants: AMA adopted a report declaring that antidepressants are beneficial and should remain available to adolescents who need them, despite criticism in recent months over the safety of the drugs (AP/Las Vegas Sun, 6/21).
  
  
• Breastfeeding: An AMA report recommended several measures to promote breastfeeding, including supporting breast pumps "as a cost-effective tool to promote breastfeeding." Members also said that public facilities should be encouraged to provide areas for nursing and breast pumping, and mothers "should not be singled out and discouraged from nursing their infants in public places."
  
  
• Doctor shortage: An AMA report stated that the United States is experiencing a shortage of physicians. Members said that the number of medical students has remained roughly constant for 20 years, while the number of patients has increased. In addition, many doctors are close to retiring as baby boomers are beginning to require more care. Moreover, many younger doctors are unwilling to work long hours. The report found that specialties that have shortages or are expected to in the future include critical care, dermatology, radiology, endocrinology, allergy and immunology, psychiatry, cardiology and geriatrics. The Association of American Medical Colleges said the United States has become "overly dependent" on foreign medical school graduates (Ritter, Chicago Sun-Times, 6/22).
  
  
• Life-sustaining treatment: AMA members voted to adopt a measure to oppose any legislation that "presumes patients would want life-sustaining treatment unless they have clearly stated otherwise," the AP/Sun reports. The policy comes in the wake of the Terri Schiavo case. Michael Williams, a Johns Hopkins Hospital neurologist who helped sponsor the measure, said, "While the (Schiavo) circumstances were heart-wrenching and compelling, they're so rare that they're not a good basis to revise existing law." The vote reaffirms existing AMA policy that it is ethical in some cases to discontinue life-sustaining treatment (AP/Las Vegas Sun, 6/22).
  
  
• Patriot Act: AMA members at the meeting discussed a provision in the Patriot Act that allows the FBI during a terrorism investigation to require a doctor to provide a suspect's confidential medical records without the patient's knowledge or consent. Those who oppose the provision said there are no known cases in which physicians have had to turn over patient records. Members concluded that AMA should not expend political capital fighting the provision.
  
  
• Ultrasounds: AMA members concluded that "ultrasound keepsakes" -- photographs and videos of fetal ultrasounds that parents can purchase -- are an "unapproved use of a medical device." There is no evidence of safety risks, but AMA members said that "exposing the fetus to ultrasound with no anticipation of medical benefit is not justified" (Chicago Sun-Times, 6/22).